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Original Article

JCDR. 2011; 2(3): 164-171


Ambulatory blood pressure profile and left ventricular geometry in Nigerian hypertensives

O. E. Ajayi, E. A. Ajayi, O. A. Akintomide, R. A. Adebayo, S. A. Ogunyemi, A. T. Oyedeji, M. O. Balogun.


Abstract

Background: Left ventricular hypertrophy (LVH) is an independent cardiac risk factor in hypertensives and
the structural classification of left ventricular (LV) geometry provides additional prognostic information.
Ambulatory blood pressure (ABP) monitoring has been shown to be superior to office blood pressure (BP) in
relation to hypertension LVH. We investigated ambulatory BP variables in relation to LV geometric patterns
in Nigerian hypertensives. Materials and Methods: A total of 130 patients (males = 96, females = 34) with
hypertension had their 24-hours ambulatory BP and trans-thoracic 2D/M- mode echocardiography. Data were
analyzed with SPSS 13.0. P < 0.05 was considered statistically significant. Results: The mean age of the
patients was 54.08±11.88 years. The prevalence rate of abnormal LV geometry was 48.4%. Mean ambulatory
Systolic BP (day time, night time and 24-hour-average) was significantly higher in patients with LVH compared
with those without LVH. Day-night systolic and diastolic BP decay (i.e. percentage nocturnal decline in BP)
was also significantly lower in LVH group than in the group without LVH. Patients with eccentric LVH had
abnormal day time mean ambulatory systolic BP, night time mean ambulatory systolic BP, elevated day time
and night time systolic BP loads, as well as non-dipping diastolic BP pattern. Significant correlates of LV
mass index in this study population were mean ambulatory systolic BP (day time: r = 0.355, P = 0.004; night
time: r = 0.343, P = 0.005; 24- hour average: r = 0.358, P = 0.004) and day-night decay (systolic: r = -0.388,
P = 0.007; diastolic: r = -0.290, P = 0.022) as well as 24-hour systolic BP variability. Conclusion: The presence
of LVH in hypertension was associated with higher mean ambulatory systolic BP and lower percentage nocturnal
decline in systolic and diastolic BP than its absence which appeared to be worse in patients with eccentric
LV geometry when compared with other geometric patterns.

Key words: Ambulatory blood pressure, left ventricular geometry, hypertensives, Nigerians






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