Cumulative Blood Pressure Load and Left Ventricular Mass

Instituto Ecuatoriano del Corazón

Status: Enrolling

Conditions: Arterial Hypertension

Treatments: Diagnostic Test: Three-dimensional transthoracic echocardiography; Diagnostic Test: 24-hour ambulatory blood pressure monitoring (ABPM)

Study type: Observational

Funder types: Other

Identifiers

NCT05465746

IECOR002

Details and patient eligibility

About

Delay in the diagnosis of systemic arterial hypertension (SAH) causes morbid hypertensive status with target organ damage (TOD). Screening and surveillance of SAH used to be performed through self-measurement of blood pressure (SMBP) or routinary in clinic blood pressure measurement (CBPM).

It is essential to determine the correlation between the cumulative blood pressure load through ABPM and the left ventricular mass identified by three-dimensional transthoracic ultrasound (3D-TTE). We postulate a directly proportional and statistically significant association between cumulative blood pressure load and left ventricular mass (LVM).

Full description

Delayed diagnosis of SAH causes a morbid hypertensive state, with target-organ damage (TOD): brain, kidney, and heart. An early diagnosis and proper follow-up of patients with SAH prevents and reduces comorbidities associated with TOD. Screening and follow-up of SAH are traditionally performed by routine self-monitoring of blood pressure (HBPM) or clinic blood pressure measurement (CBPM).

Ambulatory blood pressure monitoring (ABPM) consists of measuring BP every fifteen and thirty minutes for twenty-four hours, using a sphygmomanometer adapted to a portable monitor, which led to the recognition of SAH phenotypes often not identified through SMBP or CBPM. The ABPM offers three types of information: a) the mean BP in twenty-four hours, day and night; b) BP variability; and c) cumulative BP load. Cumulative BP load is the percentage of BP measurements above 135/85 mmHg.

Increased LVM is a consequence of chronic hypertension and early sign of TOD at the cardiac level. It has been shown that the variability in nocturnal diastolic BP correlates significantly with LVM, independently of mean BP load. It is likely that an elevated BP load according to ABPM correlates with higher TOB; however, at the moment, there is no standardized value of BP load that allows predicting the increase in the LVM. For this reason, a standardized cut-off of cumulative BP load is helpful for understanding ABPM in the screening SAH.

Enrollment: 80 estimated patients

Sex: All

Ages: 40 to 79 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Both sex
• Between 40 and 79 years old.
• Low or moderate cardiovascular risk according to the 3American Heart Association (AHA) criteria.

Exclusion criteria

• Patients with TOD defined as: the history of cerebrovascular event (CVD); chronic kidney disease (CKD) with glomerular filtration rate (GFR) <30 mL/min/1.73 m2 or under replacement therapy (renal dialysis).
• History of chronic liver disease with a Child-Pugh B or C.
• Dependence on alcohol or psychotropic drugs.
• History of cancer, regardless of stage or time of treatment.
• Patients who do not wish to participate in this study.

Trial design

80 participants in 1 patient group

Adults with an indication of SAH screening

Description:

Patients who attend the physician's office or the emergency room (ER) with signs and symptoms of high systemic arterial blood pressure will be indicated for ABPM and TTE

Treatment:

Diagnostic Test: 24-hour ambulatory blood pressure monitoring (ABPM)

Diagnostic Test: Three-dimensional transthoracic echocardiography