Clinical Hospital, Geogia
Title: Influence of circadian blood pressure pattern on left ventricular hypertrophy and thrombogenesis in hypertensive patients
Biography: Anna Rekhviashvili
Introduction: Left ventricular hypertrophy (LVH) is the most common target organ damage in arterial hypertension (AH). Hence, the association of LVH and circadian rhythm of blood pressure (BP) is still under debate. Nondipping circadian BP pattern increase risk of cardiovascular and cerebrovascular events, that may be due to the abnormalities in blood coagulation and activation of thrombogenesis
The purpose of this study is to proof hypothesis, that non-dipper hypertensive patients in comparison with dippers have an adverse blood coagulation and activated thrombogenesis, as well as more severe LVH.
Methods: 57 patients with AH and 17 controls with normal BP were included in the study. 24-hour ambulatory BP monitoring, cardiac ultrasound and examination of blood rheology, namely plasma and whole blood viscosity, fibrinogen concentration, platelet aggregation and adhesive activity was performed in all the patients according to the standard protocols. Written informed consent was obtained from all participants.
Results: Dipper pattern was revealed in 20 patients and nondipping in 37 hypertensive patients. Nondipper hypertensives in comparison with dippers had higher levels of fibrinogen concentration, plasma and whole blood viscosity, platelet aggregation, as well as adhesiveness (P<0.001). The prevalence of LVH was markedly higher among non-dipper patients with AH than among those without this disease or dipper pattern.
Conclusion: Results of our study confirm the hypothesis, that nondipper hypertensive patients in comparison with dipper hypertensive patients have statistically significant deterioration of blood rheology and have markedly higher prevalence of significant LVH. Hence, we can conclude that nondipper hypertensive patients are markedly prone to the cardiovascular complications due to the significant LVH and high risk of thrombogenesis.
Recommendations are made for the doctors involved in AH management to check blood rheology besides the LVH assessment and ABPM for proper evaluation of a patient’s potential risk and avoid possible CV complications.