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29. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Hochdruckliga e. V. DHL ® - Deutsche Hypertonie Gesellschaft Deutsches Kompetenzzentrum Bluthochdruck

23. bis 25.11.2005, Berlin

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In Order to Establish Normal Values of LVMI: Is it Enough to Consider Casual Blood Pressure?

Für die Ermittlung von Normalwerten für die LVH - reicht der Gelegenheitsblutdruck als Grundlage aus?

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  • J. Müller - Klinik Wehrawald der BfA Todtmoos (Todtmoos, D)
  • I.W. Franz - Klinik Wehrawald der BfA Todtmoos (Todtmoos, D)

Hypertonie 2005. 29. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Berlin, 23.-25.11.2005. Düsseldorf, Köln: German Medical Science; 2006. Doc05hochP41

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hoch2005/05hoch041.shtml

Published: August 8, 2006

© 2006 Müller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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Background: Casual blood pressure (cBP) readings are the gold standard for blood pressure measurement and were used in the determination of normal values for LVMI and cardiac diameters. In former studies we have shown that a hypertensive BP response to exercise and a hypertensive ABPM have been associated with typical hypertensive adaptations of the heart. Using only cBP, it is not considered that hypertensive BP regulation during exercise could have any influence on early adaptations of the heart which might be assessed as "false normal".

Methods: 1466 pts. with normotensive casual BP readings underwent standardized ergometry (50-100watts, 5 min recovery period) and ABPM (daytime<135/<85mmHg, SpaceLabs 90207). 241(f: 148, m: 93, age: 45.1±11.8y.) were identified as normotensives (normotensive casual BP, ABPM and ergometry: cBP-/ABPM-/ExBP-) and 316(f: 169 m: 147, age: 50.1±5.7y.) as hypertensives during ergometry (normotensive casual BP and ABPM, hypertensive ergometry). Additionally an echocardiography was performed.

Results: Between these two groups BP readings are significantly different (p < 0.001), excluding ABPM, of course. The echogardiographic diameters are significantly different (p < 0.001) too, excluding LV-size (p= n.s.).

Conclusions: Using the BP response during standardized ergometry and ABPM in addition to cBP, normotensive patients could be defined and valid parameters could be discovered. The results clearly show that increased exBP has a tremendous effect on LVMI with an overestimation of the upper normal values. The results might partially explain the discrepancy between the established upper limits for cardiac parameters and the existing prognostic implications for cardiovascular risk especially by ascertaining lower values.

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