Abstract
Although some treated hypertensive patients have controlled 24-h ambulatory blood pressure (ABP) despite their uncontrolled office blood pressure (BP), the factors relating to the control of 24-h ABP remain unknown. We conducted a study to assess 24-h ABP and its association with other cardiovascular risk factors, including echocardiographic left ventricular hypertrophy (LVH), in elderly hypertensive patients (n =41) with uncontrolled office BP (>140/90 mmHg) during long-term medication. Although a majority of the patients had isolated elevation of office systolic BP (SBP), there was no significant relationship between office SBP and 24-h SBP, and about half of the patients had controlled 24-h ABP (125±8/69±6 mmHg). Patients with controlled 24-h ABP (125±8/69±6 mmHg) had similar office BP (150±6/77±5 vs. 150±7/79±7 mmHg), but lower left ventricular mass index (LVMI) (123±34 vs. 156±34 g/m2) and body mass index (BMI) (24.4±2.1 vs. 26.4±3.6 kg/m2) compared with those with uncontrolled 24-h ABP (149±13/78±7 mmHg). Multivariate analysis showed that LVMI and BMI were independently associated with controlled 24-h ABP, and the control status of 24-h ABP was highly dependent on the presence of LVH and obesity. Therefore, absence of LVH and obesity may be useful for predicting the level of control of 24-h ABP in treated patients whose office BP is uncontrolled without ABP measurements. (Hypertens Res 2004; 27: 805-811)
