S-196 : Echocardiographic and ABPM parameters between 4 groups of hypertensive patients

Background: The utility of ambulatory blood pressure monitoring (ABPM) has been recognized, and the practice has been adopted widely. We investigated the clinical characteristics and ABPM profiles between patients with normotension, white coat hypertension, masked hypertension, and sustained hypertension by clinic BP and ABPM. Methods: This study is a retrospective analysis of patients with ABPM from January 2008 to May 2013. After measurement of clinic BP and ABPM, 4 groups of patients were identified namely: (i) NT: normotensive patients (BPs are normal both clinically and by ABPM) (ii) WCHT: white coat hypertensive patients (clinical BP were above limits, but ABPM were normal); (iii) MHT: masked hypertensive patients (clinical BP were normal, but ABPM were high); (iv) SHT: sustained hypertensive patients (both office and ABPM were high). Results: In total 75 patients with NT (mean age 46.5±13.7 years, female 32%), 34 patients with WCHT (mean age 51.6±13.9 years, female 50%), 201 patients with MHT (mean age 48.2±12.9 years, female 44.8%), and 83 patients with SHT (mean age 49.5±13.9 years, female 44.6%) were included. In echocardiographic findings, relative wall thickness and left ventricular mass were higher in MHT than NT (p=0.047, p=0.007) and WCHT (p=0.002, p=0.047). Subjects with NT and WCHT had similar 24 hours BP variability, and the variability among those with MHT was close to that in those with SHT. Conclusion: The short-term variability of BP is similar in MHT and SHT and higher than NT and WCHT. Left ventricular mass were higher in MHT than NT and WCHT. This results showed ABPM was more predictive of target organ damage than clinic BP and BP variability in patients with MHT may contribute to the elevated cardiovascular risk.