Association of nocturnal blood pressure and left ventricular hypertrophy in Iranian hypertensive patients

Shideh Anvari; Ehsan Noroozi; Mohammad Amin Karimi; Reza Khademi; Seyyed Kiarash Sadat Rafiei; Samira Pirzad; Nima Zabihi; Niloofar Deravi; Arezou Soltanattar; Fariba Samadian; Elham Keikha

doi:10.62347/HQQX9117

Association of nocturnal blood pressure and left ventricular hypertrophy in Iranian hypertensive patients

Am J Cardiovasc Dis. 2025 Apr 25;15(2):108-114. doi: 10.62347/HQQX9117. eCollection 2025.

Authors

Affiliations

¹ Department of Internal Medicine, Shahid Labbafinezhad Hospital, Shahid Beheshti University of Medical Science Tehran, Iran.
² School of Medicine, Shahid Beheshti University of Medical Sciences Tehran, Iran.
³ Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences Mashhad, Iran.
⁴ Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences Tehran, Iran.
⁵ School of Medicine, Islamic Azad University Tehran, Iran.
⁶ Shahid Modarres Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences Tehran, Iran.
⁷ Ali Ibn Abitaleb Medical School, Islamic Azad University Yazd Yazd, Iran.

Abstract

Objectives: Hypertension is a prevalent risk factor for cardiovascular mortality and morbidity, often leading to left ventricular hypertrophy (LVH). As ambulatory blood pressure monitoring (ABPM) gains prominence in hypertension management, it is crucial to explore its association with LVH occurrence to enhance clinical understanding and treatment strategies. This study aims to investigate the correlation between nocturnal blood pressure patterns and presence of LVH in hypertensive patients, offering insights into optimizing hypertension management strategies.

Methods: Fifty-four patients with confirmed hypertension were included in this study. All participants underwent transthoracic echocardiography within two days of admission and 48-hour ABPM within one week of admission. Based on the presence of LVH, patients were categorized into LVH and non-LVH groups. Nocturnal systolic/diastolic BP were compared between the two groups using the appropriate statistical tests.

Results: Among the 54 hypertensive patients, those with LVH (n = 22) demonstrated a significantly higher nocturnal average SBP (124.04 ± 11.92 mmHg) and DBP (76.24 ± 9.76) compared to those without LVH (n = 32, SBP = 116.78 ± 13.92 mmHg, DBP = 72.45 ± 9.76, P < 0.001).

Conclusion: This research shows a significant association between nocturnal BP patterns and the presence of LVH in hypertensive individuals. Nocturnal SBP and DBP were identified as independent risk factors for LVH. Further research, particularly on the timing of antihypertensive medication, is warranted to confirm causal relationships and improve management strategies.

Keywords: LVH; Nocturnal blood pressure; hypertension; left ventricular hypertrophy.