Capabilities of cluster analysis in interpretation of 24-hour blood pressure monitoring data in patients with arterial hypertension and left ventricular remodeling

Abstract

The aim of the investigation was to assess the potential of cluster analysis as an additional method of data analysis for 24-hour blood pressure monitoring (BPM) in patients with both normal geometry and with various types and extents of remodeling of the left ventricle (LV).Materials and Methods. The investigation included 71 patients, ranging in age from 23 to 71. The inclusion criterion was significant arterial hypertension (AH), while exclusion criteria were symptomatic AH and severe co-morbidity. Body mass, height, waist measurement, body mass index, lipid profile, and glycemic level were determined for each subject in addition to carrying out echocardiography and conventional and cluster analysis of 24-hour BPM data of each. Results. In patient groups with different types of left ventricular hypertrophy (LVH), the conventional analysis demonstrated differences in the standard 24-hour BPM parameters. Development of concentric LVH is associated with the highest average day-time and average night-time blood pressure, pressure-induced loads and blood pressure variability. Eccentric LVH has a pathogenetic link to other factors and is formed under conditions of relatively low blood pressure. The use of cluster analysis allowed to reveal the increased occurrence of systolic-diastolic AH in concentric LVH, and isolated systolic AH and isolated diastolic AH in eccentric LVH. Conclusion. Such an integrated approach to the interpretation of 24-hour BPM results, comprising both conventional and cluster analysis, allows for objectification of the study results and reveals the significant features of AH in patients with different types of LV remodeling.