Relationship of steady state and ambulatory blood pressure variability to left ventricular mass and urinary albumin excretion in essential hypertension

A relationship exists between blood pressure and cardiovascular morbidity and mortality. Recent data suggest that the variability of blood pressure is also related to hypertensive target organ damage. We studied the relationship of ambulatory daytime and night-time and supine beat-to-beat Finapres blood pressure variability to left ventricular mass index (LVMI) and urinary albumin excretion (albumin/creatinine ratio: ACR) in 33 hypertensive patients, untreated for more than 3 months. In a multiple stepwise regression model the strongest relationship with the LVMI existed for night-time systolic pressure (R = 0.46, multiple regression coefficient: 0.90± 0.26 P< .01) and daytime diastolic blood pressure variability (multiple R increased to 0.60, multiple regression coefficient 3.16 ± 1.18, P< .05). Log ACR had the strongest relationship to ambulatory systolic daytime pressure (R = 0.40, multiple regression coefficient 0.0093 ± 0.0040, P< .05) and the variability of diastolic Finapres blood pressure (multiple R increased to 0.52, multiple regression coefficient 0.081 ± 0.0036, P< .05). Both ambulatory and steady state blood pressure variability are related to early hypertensive target organ damage. This relationship exists independent of the height of blood pressure.