Left ventricular hypertrophy and stroke in hypertension

We evaluated 2,390 initially untreated hypertensive patients to determine if left ventricular hypertrophy confers increased risk for cerebrovascular events in patients with essential hypertension. After adjusting for concomitant risk factors, patients with left ventricular hypertrophy diagnosed by either electrocardiography or echocardiography were at an increased risk for stroke or transient ischemic attack. Our results suggest that left ventricular hypertrophy is an independent risk factor for cerebrovascular disease in patients with essential hypertension

Office and ambulatory blood pressure control in treated hypertension

We examined the prognostic value of 24-hour blood pressure control in 790 hypertensive subjects who underwent blood pressure monitoring before and after an average follow-up of 3.7 years. At the follow-up visit, 26.6% showed adequate blood pressure control using office values, and 37.3% showed adequate control using ambulatory values. Ambulatory blood pressure control predicted less risk for cardiovascular disease even after adjustmentfor other risk factors. We conclude that ambulatory blood pressure control is superior to office control for cardiovascular risk stratification in treated hypertensive subjects

Is systolic pressure key in determining left ventricular mass?

We studied 2,545 untreated hypertensive subjects with echocardiography and 24-hour ambulatory blood pressure monitoring to determine whether the relationship between pulse pressure and left ventricular mass is direct or mediated by other components. Left ventricular mass increased with all pressure components, and all correlations were closer with ambulatory than with office measurements. When 24-hour measures of systolic and pulse pressure values were forced into the same multivariate model, 24-hour pulse pressure lost statistical significance. Thus, systolic pressure accounts for the association between pulse pressure and left ventricular mass