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ECHOCARDIOGRAPIC MEASUREMENT OF LEFT VENTRICULAR MASS IN PATIENTS WITH MASKED HYPERTENSION, HYPERTENSION, WHITE COAT HYPERTENSION AND NORMOTENSION

ECHOCARDIOGRAPIC MEASUREMENT OF LEFT VENTRICULAR MASS IN PATIENTS WITH MASKED HYPERTENSION, HYPERTENSION, WHITE COAT HYPERTENSION AND NORMOTENSION


Author Block: D Armstrong, G Tsimiklis, D Brouillard, M Matangi
Kingston, Ontario

Abstract:
PURPOSE: To determine the differences in echocardiographic (ECHO) left ventricular mass (LVM) in patients with masked hypertension, hypertension, white coat hypertension and normotension as determined by 24hr ambulatory blood pressure monitoring (ABPM).
METHODS: ECHOfile and 24hrBPfile, the ECHO and ABPM modules of CARDIOfile, our cardiology database was searched for all patients who had both an ABPM and an ECHO within 1 year of each other. There were 16,620 ABPMs of which 2,118 patients fulfilled these criteria and were used in this analysis. One way ANOVA was used to determine significance between all means and Tukey-Kramer comparisons test between groups.
RESULTS: Of the 2,118 P, 1,069 (50.5%) were hypertensive, 584 (27.6%) were white coat hypertensive, 395 (18.6%) were normotensive and 70 (3.3%) were masked hypertensive. This is similar to the 3% of masked hypertensives in our entire 16,620 ABPMs.
The major results are seen in Table 1. Using Tukey-Kramer comparisons there is no significant difference in LV mass between masked hypertensives and hypertensives or between normotensives and white coat hypertensives. All other comparisons are statistically significant.
CONCLUSIONS: LVM is known to be a surrogate marker for subsequent cardiovascular risk in the hypertensive population. These data provide compelling support to suggest that the risks of the masked hypertensive patient is likely similar to the hypertensive patient. We advocate either 24hr ABPM or home BP monitoring to establish the diagnosis of masked hypertension.

Table 1.
. N Age (yrs) EF (%) 24hr SBP (mmHg) LV mass (g)
Masked 70 63.2+/-15.3 64.6+/-6.8 136.8+/-6.8 196.0+/-73.7
Hypertensive 1069 64.8+/-12.8 64.6+/-5.8 143.2+/-10.7 193.2+/-60.0
Normotensive 395 60.6+/-13.7 64.3+/-5.6 117.5+/-8.2 176.0+/-52.2
White coat 584 62.1+/-14.1 65.0+/-5.8 123.6+/-5.4 176.3+/-50.8
P value ANOVA . <0.0001 NS <0.0001 <0.0001


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Author Disclosure Information:  D. Armstrong, None; G. Tsimiklis, None; D. Brouillard, None; M. Matangi, None.