Abstract Background: Blood pressure (BP) has been shown to exhibit important variations not
only in the short term but also over more prolonged periods of time.
Aim: To evaluate the impact of different ambulatory BP variability indices on left ventricular
hypertrophy (LVH) in controlled hypertensive patients (Pts).
Patients and methods: Ninety controlled hypertensive Pts (office and ambulatory BP control
criteria) with mean age 55.9 ± 8.5 years were enrolled. Pts were classified into two groups:
Non-LVH group including 75 Pts with normal LV mass index and LVH group including 15 patients
with LV mass index >134 g/m2 in men and >110 g/m2 in women. Mean BP and BP load values
were obtained for the full 24 h and day-time and night-time periods. Similarly Standard
Deviation (SD) and Average Reading Variability (ARV) were calculated in all pts.
Results: Regarding office BP, Dipping status and average ambulatory BP, there was no statistically
significant difference between both groups. Meanwhile, SD of BP readings and ARV showed a
significant difference. After step-wise regression, ARV of systolic BP 24 h was the most powerful
variability index that was associated with LVH (R2= 0.944). The ROC curve analysis showed that
the discriminative power was best at more than 14.23 mmHg with sensitivity and specificity 100%
and 96% respectively for prediction of LVH.
Conclusion: The adverse cardiovascular consequences of hypertension not only depend on mean
BP values but may also depend on BPV, which independently adds to CV risk over elevated mean
BP levels