EFFECTS OF THE EARLY ONE YEAR TREATMENT IN HYPERTENSIVE LEFT VENTRICULAR HYPERTROPHY AND SIGNIFICANCE ON CARDIOVASCULAR EVENTS IN THE FUTURE: PP.22.373

Left ventricular hypertrophy (LVH) is a powerful predictor of cardiovascular morbidity and mortality. Ambulatory blood pressure monitoring (ABPM) has been proved to be superior to clinic blood pressure measurement for cardiovascular risk stratification and LVH. Objective: The aim of the present follow-up study was to evaluate the prognostic significance of the early investigated parameters as well as the effects of the changed investigated parameters after 12 month treatment on the long term prognosis of the patients with hypertensive LVH. Patients and Methods: A total of 73 age matched, no diabetic, hypertensive male (n = 44, aged 55.4 ± 8 years) and female (n = 29, aged 57.3 ± 6 years) patients with echocardiographically proved LVH, were analyzed for cardiovascular death, fatal or non-fatal myocardial infarction and stroke and revascularization procedures after 12 year follow-up. Each patient underwent: Doppler Echocardiography, Exercise stress testing, 24-hour ABPM, Holter monitoring and heart rate variability (standard deviation of all 24-hour NN intervals (SDNN, ms). Results: After 12 years of observation, 12 patients (16%) had serious cardiovascular incidents and 6 died (8%). Presence of metabolic syndrome at the beginning of the study influenced the appearance of significant cardiovascular events and death, one year earlier than in patients without MS. Multivariant analysis of investigated parameters after one year treatment showed that the death risk increases the missing of average daily diastolic BP (1.419; (95% CI for Exp(B)-1,049–1.918; p = 0.023), rising of the average night systolic BP (1.206; (95% CI for Exp(B)-1,039–1.399; p = 0.014) as well as rising of average night heart rate(1.306; (95% CI for Exp(B)-1,023–1.668; p = 0.032). Increasing of LVM index (1.014; 95% CI for Exp(B)-1,002–1.026; p = 0.026) and higher decrease of night diastolic BP (1.247; 95% CI for Exp(B)-1,083–1.437; p = 0.002). suggest the risk of both significant cardiovascular events and death. Conclusion: Increase of LVM index and poor 24 hour BP regulation are major predictors of future serious cardiovascular incidents in hypertensive patients with LVH.