Structural cardiovascular alterations and blood pressure variability in human hypertension

Giuseppe Mancia, Cristina Giannattasio, Davide Turrini, Guido Grassi, Stefano Omboni

Research output: Contribution to journalArticle

Abstract

Aim: To evaluate the cardiovascular risk of hypertensive patients in relation to left ventricular hypertrophy, arteriolar hypertrophy and blood pressure variability, and the effects of anti hypertensive treatment. Left ventricular hypertrophy: In hypertensive subjects with marked left ventricular hypertrophy, cardiovascular problems are about three times more frequent than in hypertensives who do not have left ventricular hypertrophy. The evidence suggests, however, that a moderate degree of left ventricular hypertrophy may be compensatory and that regression of mild hypertrophy should not necessarily be pursued. Arteriolar hypertrophy: An increased wall to lumen ratio leads to an increase in vascular resistance and thus promotes hypertension. Regression of this alteration with antihypertensive treatment appears to be both beneficial and achievable, although it is not clear whether all antihypertensive agents have the same effect. Moreover, there are methodological problems in determining whether a regression has actually been achieved. Blood pressure variability: There is evidence to suggest that end-organ damage is more frequent and more marked in hypertensives with greater 24 h blood pressure variability. It appears that antihypertensive treatment does not easily reduce this variability, although the intermittent measurements taken by automatic monitoring devices do not fully reflect patterns of blood pressure variation. It may be that hypertensives with a greater degree of blood pressure variability can obtain a reduction in the magnitude of this variability with antihypertensive treatment.

Original languageEnglish
Pages (from-to)S7-S14
JournalJournal of Hypertension
Volume13
Publication statusPublished - 1995

Keywords

  • Arterial compliance
  • Blood pressure variability
  • Essential hypertension
  • Structural alterations

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Internal Medicine

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