Predictors of Left Ventricular Hypertrophy in Hypertensive Patients in Assiut Governorate

Many cohort studies have demonstrated that hypertension is a strong risk factor for total mortality and cardiovascular disease (CVD) in both developing and developed countries.

Although brachial blood pressure (BP) mea¬surements have been used for over a century more and more data suggest that measuring of brachial BP has important limitations. First, a few office BP readings may not be representa¬tive of BP during a patient's daily life. Second, brachial BP may differ from systolic BP mea¬sured at the level of the ascending aorta, i.e. central BP, which is responsible for left ventri¬cle afterload and determines blood flow through coronary and brain arteries .

Recent data from the Strong Heart Study confirm earlier results from smaller studies on high-risk patients that central pulse pressure is superior to brachial pulse pressure in the prediction of further cardiovascular events.

The results of the Conduit Artery Function Evaluation (CAFE) study reminded clinicians of the importance of CBP. Those results demonstrated significant differences in CBP (central SBP and PP) between patient groups treated with different antihypertensive regimens even though peripheral BP levels were comparably lowered, and suggested the potential superiority of CBP to cuff brachial BP in cardiovascular prognostic predictive value in hypertensive patients.

Modifiable risk factors for CVD that are common among adults with hypertension include cigarette smoking/tobacco smoke exposure, DM, dyslipidemia (including high levels of low-density lipoprotein cholesterol or hypercholesterolemia, high levels of triglycerides, and low levels of high-density lipoprotein cholesterol), overweight/obesity, physical inactivity/low fitness level, and unhealthy diet .