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Non-dipper treated hypertensive patients do not have increased cardiac structural alterations
Cesare Cuspidi1, Iassen Michev, Stefano Meani
1Clinica Medica Generale e Terapia Medica, Centro Interuniversitario di Fisiologia Clinica e Ipertensione, Ospedale Maggiore Policlinico IRCCS, Milan, Italy. dhipertensione@libero.it
Cardiovascular Ultrasound
|April 24, 2003
Summary
The non-dipping blood pressure pattern in treated hypertensive patients does not correlate with increased cardiac damage like left ventricular hypertrophy. A single ambulatory blood pressure monitoring is insufficient to identify patients with greater cardiac alterations.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Diagnostics
Background:
- Non-dipping blood pressure (BP) is linked to target organ damage and poor outcomes in hypertensive patients.
- Reduced nocturnal BP fall is a potential indicator of cardiovascular risk.
- Assessing the relationship between non-dipping and cardiac alterations is crucial for risk stratification.
Purpose of the Study:
- To investigate if a reduced nocturnal fall in blood pressure (BP) in treated essential hypertensives is associated with more prominent cardiac alterations.
- To determine the relationship between the non-dipping BP pattern and left ventricular hypertrophy (LVH) prevalence.
- To evaluate if a single 24-hour BP monitoring can identify hypertensive patients with greater cardiac damage.
Main Methods:
- 229 treated essential hypertensive patients underwent clinic BP measurement, blood/urine sampling, ECG, echocardiography, and ambulatory BP monitoring (ABPM).
- Patients were categorized into three groups based on BP control and refractory hypertension criteria.
- Left ventricular hypertrophy (LVH) was defined using established gender-specific criteria.
Main Results:
- 51.9% of participants were non-dippers (fall in systolic/diastolic BP < 10% during the night).
- Non-dipper prevalence was higher in refractory hypertension (group III) compared to controlled (group I) and uncontrolled (group II) hypertension.
- No significant differences in cardiac structure or LVH prevalence were found in relation to dipping or non-dipping status across the groups.
Conclusions:
- The extent of nocturnal BP decrease is not associated with increased LV mass or LVH prevalence in treated essential hypertensives.
- The non-dipping profile, identified by a single ABPM, does not reliably identify hypertensive patients with greater cardiac damage.
- Current findings suggest that non-dipping status alone may not be a sufficient predictor of cardiac alterations in this patient population.