determinants of left ventricular hypertrophy in essentially hypertensive patients

determinants of left ventricular hypertrophy in essentially hypertensive patients 关于铁凝的作文 放牛班的春天观后感 Determinants of left ventricular hypertrophy in essentially hypertensive patients P-364ARE THERE ANY PARTICULARITIES OFAMBULATORY BLOOD PRESSURE MONITORINGVALUES IN HYPERTENSIVE PATIENTS WITHRESISTANT LEFT VENTRICULAR HYPERTROPHY?Zhanna D. Kobalava, Ioulia V. Kotovskaia, Ioulia L. Karaulova, ElenaP. Korovina, Valentine S. Moiseev. Department of Internal Medicineand Pharmacotherapy, Russian Peoples’ Friendship University,Moscow, Russian Federation.The objective of the study was assessment of ABPM values changesduring one-year antihypertensive therapy in essentially hypertensive(EH) patients with and without regression of left ventricular hypertrophy(LVH). Standard ABPM was performed after 4 weeks of placebo and inone year of antihypertensive treatment in 40 (16 men, 24 women) EHpatients with echocardiographically verified LVH (LV mass index[LVMI] ?120 g/sq.m in men and ?100 g/sq.m in women). Group 1included 17 patients with resistant LVH (LVMI decrease ?10% com-paring to baseline), Group 2 included 23 patients with regression of LVH(LVMI decrease ?10% comparing to baseline).At baseline Group 2 had higher values of day- and nighttime pulsepressure (PP) than Group 1 (respectively 58,0?1,4 vs 53,0?1,5 mmHg,52,4?1,7 vs 46,0?1,7 mmHg, p?0,05) and higher daytime systolic BPvariability (16,2?0,2 vs 14,8?0,5 mmHg, p?0,05). In Group 2 SBP/DBP decrease was 5,4%/ 5,6% during 24h, 5,3%/6,7% during daytime,7,4%/7,6%- during nighttime. In Group 1 respectively 5,5%/6,6%, 6,7%/8,4%, 6,9%/6,3%. Decrease of daytime PP was 2,4% (p?0,05 to base-line) in Group 1 and 10,2% (p?0,05 to baseline and to Group 1) in Group2. Decrease of nighttime PP was respectively 8,7% (p?0,05 to baseline)and 10,7% (p?0,05 to baseline). No significant difference in ABPMvalues achieved at the end of treatment between groups was revealed.Significant decrease of variability of daytime systolic BP (from 16,2?0,2to 14,5?0,2 mmHg, p?0,05) and nighttime PP (from 13,8?0,4 to12,4?0,2 mmHg, p?0,05) was observed in Group 2. In Group 1 BPvariability changes were not significant. Diurnal index (DI) increased inGroup 2 (systolic from 9,6?1,1% to 13,6?1,2%, p?0,05, and diastolicfrom 12,4?1,0% to 14,2?1,5%, p?0,05). In Group 1 DI changedrespectively from 12,8?1,6% to 13,0?1,2% and from 15,3?2,0% to13,7?1,2% (p?0,05 in both cases). Baseline LVMI correlated (Spear-men analysis) to 24-h (r?0,54) and nighttime (r?0,62) systolic BP,daytime (r?0,66) and nighttime (r?0,70) PP. In Group 2 LVMI changessignificantly correlated to changes of daytime and nighttime PP (r?0,56and r?0,62). No significant correlation between changes of LVMI andABPM values was revealed in Group 1.The data obtained suggested no specific features of ABPM profile inpatients with resistant LVH. Correlations between PP and LVMI changessuggest important role of PP as a risk factor either for LVH per se andresistant LVH.Key Words: Left Ventricular Hypertrophy, Blood Pressure Monitoring,Arterial HypertensionP-365DETERMINANTS OF LEFT VENTRICULARHYPERTROPHY IN ESSENTIALLY HYPERTENSIVEPATIENTSIoulia V. Kotovskaia, Zhanna D. Kobalava, Ioulia L. Karaulova, ElenaP. Korovina, Valentine S. Moiseev. Department of Internal Medicineand Pharmacotherapy, Russian Peoples’ Friendship University,Moscow, Russian Federation.The study objective was to investigate genetic, demographical, hemody-namical and biochemical factors of LVH in essentially hypertensive (EH)pts.We observed 68 EH pts (26 men and 40 women, 音乐剧猫 昆虫记读后感 禁毒感想 金色的鱼钩 关于铁凝的作文 放牛班的春天观后感 mean age 54,03?1,5years) with echocardiographically confirmed LVH (Devereux formularLVMI for male by ? 120 g/m2 and ?100 g/m2 for female). Genotypesand alleles distribution of I/D polymorphism of ACE gene, T174Mpolymorphism of AGT and A1166C polymorphism of AT1 receptor,serum cholesterol (Ch), creatinine (Cr), glucose (Gl), uric acid (UA) andleukocytes levels were assessed. Statistical Spearmen and multiple re-gression analysis were done to determine contribution of factors intoLVH.Frequency of D-allele was 63,3 % (genotype DD - 39,3%, ID - 50%).Genotype II was two fold more frequent in men than in women (17,9%vs 7,5%). The frequency of M-allele was 27,9% (genotype MM - 10,2%,TM - 35,3%). The frequency of C-allele was 25,8% (genotype CC -4,4%, AC - 33,8%) and did not differ significantly from previouslyobserved frequency in healthy Moscow population. LVMI significantlycorrelated with systolic BP (r?0,37), male gender (r?0,36), pulse pres-sure (r?0,31), heart rate (r?-0,33) and leukocytes level (r?0,30). Inwomen correlation between LVMI and age (r?0,32), systolic BP(r?0,41) and pulse pressure (r?0,41) was revealed. In men LVMIsignificantly correlated with serum level of UA (r?0,65), Gl (r?0,59), Cr(r?0,45) and Ch (r?0,39). The results obtained supposed high frequencyof D-allele and DD-genotype of ACE gene polymorphism and M-alleleand MM genotype of T174M AGT gene polymorphism in untreatedpatients with EH and LVH. Haemodynamic risk LVH factors are ofimportance in female patients whereas metabolic factors - in male ones.Key Words: Arterial Hypertension, Left Ventricular Hypertrophy, GenePolymorphismP-366MORNING RISE IN BLOOD PRESSURE ASSOCIATESWITH LEFT VENTRICULAR HYPERTROPHY ANDINSULIN RESISTANCE IN TREATED HYPERTENSIVEPATIENTSTomoko Gomi, Kiyoko Matsuo, Takeshi Kosugi, Yuko Shibuya, ToshioIkeda. Department of Nephrology, NTT Kanto Medical Center, Tokyo,Japan.Blood pressure rise in early morning is considered as an important riskfactor for vascular complications of hypertension. The aim of this studyis to clarify the characteristics of hypertensive patients who had a bloodpressure rise in the morning judged by home blood pressure monitoring.The subjects enrolled in this study were 179 male patients (mean age;57.1?9.9 years) with primary hypertension under the treatment withantihypertensives more than 1 year, and whose systolic blood pressuresat bedtime were controlled below 135 mmHg. Subjects were instructedon how to measure their own blood pressures at home by nursing stuffs.Monitor used in this study was cuff-oscillometric devise (Omron HEM-737 IntelliSense, Omron, Tokyo), which was checked by connecting tothe sphygmomanometer with a Y-connector at monthly clinic visits.Subjects were asked to measure their home blood pressure in the morningwithin 30 minutes after awakening and in the evening just before goingto bed. Blood pressure values used in this study were only daily datawhen blood pressure measurement was done both in the morning and inthe evening. Subjects were divided into 2 groups according to thedifference of systolic blood pressure between morning and evening(M-SBP-E-SBP); morning rise group (MR)? M-SBP-E-SBP?10mmHg(n?64)andnon-morningrisegroup(NMR)?M-SBP-E-SBP??10mmHg (n?115). Two-dimension guided M-mode echocardio-grams of left ventricle were recorded. End-systolic and end-diastolicmeasurements of left ventricular internal dimension, interventricular sep-tal thickness, and left ventricular posterior wall thickness were madeaccording to the American Society of Echocardiography recommenda-tions. Left ventricular mass index was calculated using the formulaintroduced by Devereux et al.MR had increases in body mass index (25.6?3.3 vs 24.0?3.0 kg/m2,p?0.0024), relative wall thickness (0.450?0.076 vs 0.426?0.062,p?0.0300), and left ventricular mass index (128?26 vs 98?14 g/m2,p?0.0001). Fasting insulin increased in MR compared to NMR(8.89?6.96 vs 6.78?4.07 ?U/ml, p?0.0174) 音乐剧猫 昆虫记读后感 禁毒感想 金色的鱼钩 关于铁凝的作文 放牛班的春天观后感 ;April 2002–VOL. 15, NO. 4, PART 2POSTERS: Heart Failure/Hypertrophy 音乐剧猫 昆虫记读后感 禁毒感想 金色的鱼钩