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ȣ - 550917 136 |
| Correlation between left ventricular mass and blood pressure according to the blood pressure measurement methods in Kor-ABP study |
| 한양대학교 의과대학 내과¹ , 전남대학교 의과대학 내과², 연세대학교 의과대학 내과³, 가톨릭대학교 의과대학 내과⁴, 서울대학교 의과대학 내과 5, 경희대학교 의과대학 내과 6, 이화여자대학교 의과대학 내과7 |
| 신진호¹ , 김주한², 박성하³, 임상현⁴,김광일 5, 김우식6, 편욱범7, 김순길¹ |
Background : The relationship between left ventricular(LV) mass and blood pressure(BP) is affected by BP measurement methods. Ambulatory blood pressure (ABP) is known to be better in the correlation than clinic blood pressure(CBP). Considering the standardization in CBP measurement and racial difference in the LV size, there is no enough data regarding the relationship between LV mass and BP in Korean subjects.
Methods : 712 subjects among 1916 subjects in KORABP data base underwent echocardiographic examination were analyzed. The correlation coefficient between LV mass and BP was compared according to the BP measurement methods, i.e., CBP versus ABP. Other covaraites related to LV mass such as age, gender, anti-hypertensive medication(M), and body mass index(BMI) were adjusted. CBP was measure by A&D UA-767® and ABPM was measured by clinician’s discretion. Echocardiographic LV mass were measured by ASE-leading to leading edges.
Results : Age was 56.1 ± 14.4. 50.9% was female. Blood pressures were higher in CBP than in ABP in systolic BP(SBP) and diastolic BP(DBP), respectively( 144.1 ± 21.5 / 88.5 ± 14.9 mmHg vs 136.6 ± 15.7 / 72.9 ± 10.3 mmHg, p < 0.0001). LV mass index(LVMI) were 102.7 ± 28.5 g/m2 and 47.3 ± 14.3 g/m2.7. The adjusted correlation coefficient between the two indexation methods was 0.982. Adjusted correlation coefficients between LVMI(g/m2) and blood pressures were 0.130 in CBP (p=0.001), 0.151 in daytime SBP( p < 0.001), 0.194 in nocturnal SBP( p < 0.0001), and 0.087 in 24 hour SBP ( p = 0.026). Regarding DBP, only nocturnal DBP was significantly associated with LVMI( r = 0.171, p < 0.0001). Stepwise multiple regression analysis showed that BMI ( β=0.082, p = 0.031), nocturnal SBP ( β = 0.189, p < 0.0001), age ( β = 0.205, p < 0.0001), and female ( β = - 0.132, p = 0.001) were independent factors for LVMI(g/m2.7).
Conclusion : Our study showed that nocturnal systolic blood pressure is the strongest related factor for LV hypertrophy among various BP parameters for mean BP. Clinic BP measured by automated device is also significantly correlated with LVMI.
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