Comparison of ambulatory and clinical blood pressures, and their correlation with organic heart damage, in the elderly

Summary blood pressure (BP) measurements may sometimes indicate the presence of cardiovascular morbidity and mortality, but the correlations between BP values and the subsequent occurrence of such complications are low. This may depend on the known inability of casual BP measurements to reflect accurately the 24-hour mean and overall profile of the BP. In this study, electrocardiography (ECG) of left ventricular muscle mass was related to various measures of BP during circadian ambulatory BP monitoring in 156 hypertensive and nonhypertensive elderly patients. Multiple regression analysis performed to establish the presence of left ventricular hypertophy (LVH) revealed that the product of ambulatory systolic BP x diastolic BP (p = 0.027) and ambulatory diastolic BP were significant variables. Clinical pressure variables were not significant. Multiple linear regression analysis to establish the degree of LVH in function of the pressure variables generated a model where the variables included are the product of ambulatory systolic BP x diastolic BP (p = 2.7 × 10−8), ambulatory systolic BP (p = 7.8 × 10−6) and ambulatory diastolic BP (p = 2.4 × 10−6). Results obtained agree with the literature and revealed that LVH evaluated using ECGRomhilt-Estes score was correlated in terms of presence/absence of organ damage and in terms of score to ambulatory monitoring values.