Schillaci G, Verdecchia P, Borgioni C, et al
Association between persistent pressure overload and
ventricular arrhythmias in essential hypertension
(Aug) 28:284-289 1996
Patients in whom blood pressure does not decrease at night (non-dippers)
appear to be at increased
risk of end-organ damage, including LVH and microalbuminuria. As
hypertension puts patients at
increased risk for sudden cardiac death, the present paper studies risk
factors for complex
ventricular arrhythmias in hypertensive patients as a function of both LVH
and their Continuous
ambulatory BP profile.
One hundred twenty six previously untreated hypetensives were studied. The
absence of treatment
eliminated the potential confounding effect of previous therapy with
diuretics, which may induce
hypokalemia and increase the risk of arrhythmia, or beta blockers, which may
decrease this risk.
All patients had continuous ambulatory BP recording and measurement of LV
mass by M-mode echo.
Coronary artery disease was excluded, but only when clinically suspected, by
exercise testing and/or
During 24 hour ECG monitoring premature ventricular beats (PVBs) were
detected in 71% of subjects. When the Lown class of
arrhythmia was plotted against the degree of nocturnal BP reduction, a
substantial inverse correlation was
found. Dippers had an average of about 100 PVB/24 hours, versus about 600
PVB/24 hours were found in non-
dippers. The number of PVBs was markedly increased in patients with LVH vs.
LVH and a non-dipping BP pattern are usually correlated, but in a multiple
regression analysis, both LVH and non-dipping BP pattern appeared to
independently increase the
chances of PVBs and complex arrhythmias.
(John T. Daugirdas, M.D., University of Illinois at Chicago)
The full text of this abstract is available from the AHA at: