Introduction: Blood Pressure (BP) of an individual has a strong implication for cardiac remodeling in different level of tissues even from the cellular level. Objectives: The study was aimed to explore the association of different ambulatory BP variables on echocardiographic evidences of cardiac remodeling, diastolic dysfunction and Ambulatory Arterial Stiffness Index (AASI). Methodology: A descriptive cross-sectional study was conducted at Cardiology Unit, Kandy in 2015, recruiting consecutive sample of 100 essential hypertensive patients with normal renal functions and no history of ischemic cardiovascular events. Ambulatory BP monitoring and echocardiographic evaluations were performed in all the patients. Results: The study sample included 100 subjects; consisted of 72% females (mean age 60.86±8.73 years). There were 48% had mild Left Ventricular Hypertrophy (LVH), 27% had moderate LVH and 7% had severe LVH. IVS thickness had a positive correlation with 24-hour average ambulatory systolic BP (r=0.3, p<0.01) and 24-hour average ambulatory diastolic BP (r=0.28, p<0.01). There was a positive correlation found between average day time systolic BP and Left Ventricular Mass (LVM) (r = 0.29, p < 0.006) and average nocturnal systolic BP (r=0.34, p=0.009). Similarly, there was a statistically significant positive correlation noted between day time average diastolic BP and LVM (r=0.269, p=0.008) and average nocturnal diastolic BP (r=0.4, p=0.024). In the study sample 23.68% and 76.31 % had grade I and II diastolic dysfunction respectively. AASI showed a positive correlation with 24-hour average systolic BP (r=0.02 p=<0.001), average nocturnal systolic BP (r=0.357, p<0.001) and average pulse pressure (r=0.562, p<0.001). Conclusion: Occurrence of altered LV geometry, as a marker of cardiac remodeling in hypertension and AASI, best correlate with several ambulatory BP parameters. Therefore, evaluation of BP by ambulatory monitoring can be used as a one of a sensitive tool for the evaluation of hypertensive cardiac remodeling.
