Capabilities of Cluster Analysis in Interpretation of 24-Hour Blood Pressure Monitoring Data in Patients with Arterial Hypertension and Left Ventricular Remodeling

Purpose: to study the association of blood pressure (BP) visit-to-visit variability (VVV) with non-valvular atrial fibrillation (AF) in rural dwellers with arterial hypertension (HTN). Material and methods. The cross-sectional study retrospectively analyzed complex data from consecutive 160 males with primary HTN (mean age 50 ± 6 years). Patients with major HTN complication were excluded. We analyzed the office systolic BP (SBP) and diastolic BP (DBP) levels, obtained at four consecutive doctor`s visits. As a metric of BP VVV, we used standard deviation (SD) and coefficient of variation (CV) values. The criteria for high BP VVV were Patients were ascertained to have high BP VVV in case of SD (SBP) ≥15 mm Hg and/or SD (DBP) ≥14 mm Hg. Totally, high BP VVV status was in 82 (51,3 %) patients. Paroxysmal AF was detected in 29 (18,1 %) patients. Results. HTN with AF group (vs. HTN alone) was characterized by higher average values of BB VVV metrics (median, interquartile range): SD (SBP) (16,7 (15,9-17,5) vs. 8,7 (4,6-15,2) mm Hg, respectively); SD (DBP) (11,5 (8,9-14,6) vs. 5,7 (3,9-8,9) mm Hg, respectively); CV (SBP) (10,1 (9,6-10,7) vs. 5,6 (2,9-9,2) %, respectively); and CV (DBP) (12,9 (9,3-15,5) vs. 6,3 (4,1-9,7) %, respectively) (р<0,001 in all the comparisons). Additionally, HTN with AF group associated with worse kidney filtration function (estimated glomerular filtration rate (eGFR): 57 (53-59) vs. 67 (62-77) ml/mim/1,73 m2, respectively) and more pronounced albuminuria (urine albumin/creatinine ratio (A/Cu): 36,1 (32,3-40,6) vs. 10,3 (6,5-26,9) mg/mmol, respectively) (р<0,001 in both comparisons). While integral assessment of eGFR and A/Cu values, we determined higher frequency of patients with high and very high cardiovascular and renal adverse events risk (AER) in HTN with AF group. Moreover, patients with HTN and AF presented with higher left atrial antero-posterior dimension (LAD) (4,3 (4,2-4,6) сm vs. 3,9 (3,6-4,1) cm, respectively; р<0,001), as well as with more advanced left ventricular remodeling. At multivariable analysis, SD (SBP) ≥15 mm Hg and SD (DBP) ≥14 mm Hg, along with AER and LAD, were the most significant factors independently associated with AF. Conclusion. In rural males with HTN, the presence of high BP VVV is one of the factors associated with non-valvular AF risk increase. High BP VVV could be proposed as an additional modified AF risk factor in patients with HTN.

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Specifics of Left Ventricular Remodeling and Daily Blood Pressure Profiles in Young and Middle-Aged Servicemembers Dealing with Arterial Hypertension

Indian Journal of Forensic Medicine & Toxicology ◽

10.37506/ijfmt.v14i4.12842 ◽

2020 ◽

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Ventricular Remodeling ◽

Left Ventricular Remodeling ◽

Left Ventricular ◽

Middle Aged ◽

Pressure Profiles

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Use of ambulatory blood pressure monitoring data to predict left ventricular mass in hypertension

Blood Pressure Monitoring ◽

10.1097/00126097-200104000-00002 ◽

2001 ◽

Vol 6 (2) ◽

pp. 73-80

Author(s):

Jean-Philippe Baguet ◽

Régis De Gaudemaris ◽

Anestis Antoniadis ◽

Frédéric Tremel ◽

Jean-Philippe Siché ◽

...

Keyword(s):

Blood Pressure ◽

Left Ventricular Mass ◽

Ambulatory Blood Pressure Monitoring ◽

Ambulatory Blood Pressure ◽

Blood Pressure Monitoring ◽

Left Ventricular ◽

Monitoring Data ◽

Pressure Monitoring ◽

Ventricular Mass

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C064 The correlation between the ambulatory blood pressure monitoring (ABPM) data with the presence of left ventricular hypertrophy (LVH) in the systemic arterial hypertension (SH)

American Journal of Hypertension ◽

10.1016/s0895-7061(97)90939-0 ◽

1998 ◽

Vol 11 (4) ◽

pp. 63A

Author(s):

L COSTA

Keyword(s):

Blood Pressure ◽

Left Ventricular Hypertrophy ◽

Arterial Hypertension ◽

Ambulatory Blood Pressure Monitoring ◽

Ambulatory Blood Pressure ◽

Ventricular Hypertrophy ◽

Blood Pressure Monitoring ◽

Left Ventricular ◽

Pressure Monitoring ◽

Systemic Arterial Hypertension

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Predicting the risk of left ventricular hypertrophy in children and adolescents with arterial hypertension on the basis of 24-hour blood pressure monitoring and metabolism indicators

Journal of Internal Medicine: Science & Art ◽

10.36013/jimsa.v1i1.16 ◽

2020 ◽

Vol 1 ◽

Author(s):

Tamara Haiduk ◽

Olha Haiduk ◽

Irene Gubar

Keyword(s):

Blood Pressure ◽

Left Ventricular Hypertrophy ◽

Arterial Hypertension ◽

Children And Adolescents ◽

Ventricular Hypertrophy ◽

Blood Pressure Monitoring ◽

Left Ventricular ◽

Control Group ◽

Immunoreactive Insulin ◽

Pressure Monitoring

Abstract: Objective: To investigate the significance of 24-hr ambulatory blood pressure monitoring (ABPM) data and metabolism indicators, as well their correlation in predicting the risk of left ventricular hypertrophy (LVH) in children and adolescents with arterial hypertension (AH). Methods: We studied 118 children and adolescents, M±m 15.51±0.25 yrs, Boys/Girls – 104/14, with AH: 60 stable, 40 labile, 18 prehypertension (high-normal blood pressure), and a control group of 13 normotensive children, M±m 15,19±0,41 yrs, Boys/Girls – 10/3. All patients underwent a comprehensive anamnestic, clinical, laboratory, and instrumental examination, including 24-hr ABPM; indicators were standardized by gender and age. On Doppler echocardiography (echoCG), the left ventricular myocardial mass index (LVMI) was calculated. Lipid spectrum parameters were determined by biochemical method, venous blood glycemia by GOD-PAP, blood serum basal immunoreactive insulin by ELISA methods, insulin resistance (IR) by HOMA parameters calculation. Statistical processing was performed using the package of statistical analysis software STATISTICA. Results: Of a range of metabolism indicators, BMI, TG level, LDL/HDL ratio, HOMA index, 24-hr DBP index, and the stable character of AH identified as the most significant factors in predicting the risk of LVH in hypertensive children. All multivariate models of logistic regressions, which include BMI, can predict the probability of LVH with an accuracy of 79.7-84.7%, sensitivity - 57.5-77.5%, specificity - 86.4-91.0%. Conclusions: Obtained satisfactory concordance of the actual data with predictive models' results indicate the possibility of their use to predict the risk of LVH in children and adolescents with AH.

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Left ventricular myocardial dysfunction and parameters of ambulatory blood pressure monitoring in patients with arterial hypertension and frailty

Consilium Medicum ◽

10.26442/20751753.2021.1.200476 ◽

2021 ◽

Vol 23 (1) ◽

pp. 80-83

Author(s):

Elena S. Fomina ◽

◽

Elena S. Fomina ◽

Viktor S. Nikiforov ◽

Elena V. Frolova ◽

...

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Diastolic Function ◽

Ambulatory Blood Pressure Monitoring ◽

Ambulatory Blood Pressure ◽

Blood Pressure Monitoring ◽

Myocardial Dysfunction ◽

Left Ventricular ◽

Pressure Monitoring ◽

Time Index

Aim. To study and analyze the systolic and diastolic left ventricle (LV) function, parameters of the ambulatory blood pressure (BP) monitoring in patients over 65 years of age with arterial hypertension, depending on the presence of frailty. Materials and methods. We examined 77 patients over 65 years of age (25 men and 52 women) with arterial hypertension, who were divided into two groups: with the presence of frailty (38 people) and its absence (39 people). To detect frailty, we used the "Age is not a hindrance" questionnaire validated in Russia and the "Get up and go" test. The examination included echocardiography with tissue doppler and ambulatory BP monitoring. Results. In both groups, LV systolic function remained within normal values, while diastolic function was impaired. In the group of people without frailty, type 1 of left ventricular diastolic dysfunction prevailed in 63% of cases, in the group with frailty, type 2 of left ventricular diastolic dysfunction with increased filling pressure was registered in 77% of cases. In both groups, both isolated systolic arterial hypertension and normal indicators of SBP and DBP were recorded during the day. Systolo-diastolic hypertension and hypotension have been presented by individual cases. At the same time, significant differences (p<0.05) in the groups were revealed by the index of time of hypertension SBP at night and were higher in patients with frailty. Correlations were found between the time index of hypertension and SBP at night with the volume index of the left atrium in groups with frailty (0.34; p<0.05) and without frailty (0.40; p<0.05), as well as the time index of hypertension and SAD at night with the maximum rate of regurgitation on the tricuspid valve (0.42; p<0.05) and with estimated systolic pressure in the pulmonary artery (0.41; p<0.05) in the group with frailty. Conclusion. In the group of patients with arterial hypertension older than 65 years without frailty, violations of the left ventricular diastolic function by the type of slowing relaxation predominate, while in the group of patients with senile asthenia, violation of the left ventricular diastolic function by the type of pseudonormalization with increased filling pressure prevails. Features of the ambulatory BP monitoring of patients with hypertension older than 65 years with the presence of frailty are higher values of the time index of hypertension SBP at night. An increase in the time index of hypertension and SBP in patients with hypertension older than 65 years with frailty is associated with an increase in the volume of the left atrium, the rate of tricuspid regurgitation and systolic pressure in the pulmonary artery. The obtained data may indicate an adverse effect of frailty on the progression of heart failure in patients with arterial hypertension, which requires a comprehensive approach with the participation of a geriatrician in the management of such patients. Keywords: arterial hypertension, frailty, echocardiography, left ventricle, systolic function, diastolic function, ambulatory blood pressure monitoring, blood pressure For citation: Fomina ES, Nikiforov VS, Frolova EV, Reshetnik DA. Left ventricular myocardial dysfunction and parameters of ambulatory blood pressure monitoring in patients with arterial hypertension and frailty. Consilium Medicum. 2021; 23 (1): 80–83. DOI: 10.26442/20751753.2021.1.200476

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