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The effect of nondipping blood pressure patterns on cardiac structural changes and left ventricular diastolic

Ahmet Soylu1, Mehmet Akif Duzenli, Mehmet Yazici

  • 1Department of Cardiology, Meram Medical School of Selcuk University, Konya, Turkey. asoylu44@gmail.com

Echocardiography (Mount Kisco, N.Y.)
|December 5, 2008
PubMed

Insights

Nondipping nocturnal blood pressure in normotensive individuals is linked to cardiac remodeling and left ventricular diastolic dysfunction. This "nondipping" status may indicate cardiovascular risk even without increased left ventricular mass.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Cardiovascular Physiology

Background:

  • Cardiac structural changes are more pronounced in nondipper normotensives compared to dippers.
  • The impact of nondipping status on cardiac diastolic function in normotensives remains understudied.
  • This study investigates the effects of nondipping status on cardiac structure and left ventricular (LV) diastolic function in normotensive individuals.

Purpose of the Study:

  • To determine the influence of nondipping status on left ventricular (LV) diastolic function in normotensive subjects.
  • To assess cardiac structural changes associated with nondipping in normotensive individuals.
  • To evaluate the relationship between nondipping and cardiovascular risk markers in normotension.

Main Methods:

  • Ambulatory blood pressure monitoring (ABPM) and echocardiography were conducted in 62 normotensive participants.
  • Participants were selected based on office BP < 140/90 mmHg and average 24-hour ambulatory BP < 130/80 mmHg.
  • Tissue Doppler imaging (TDI) was utilized to assess diastolic function parameters.

Main Results:

  • Nondippers exhibited lower early diastolic myocardial peak velocity (Em) and Em/late diastolic myocardial peak velocity (Am) ratio compared to dippers (P = 0.009 and P < 0.001).
  • Isovolumetric relaxation time (IRT) and myocardial performance index (MPI) were elevated in nondippers versus dippers (P = 0.036 and P = 0.026).
  • Nondipping status independently predicted decreased Em and Em/Am ratio, and increased IRT.

Conclusions:

  • Nondipping of nocturnal blood pressure is a significant factor in cardiac remodeling and left ventricular diastolic dysfunction (LVDD) in normotensives.
  • The nondipping pattern may signify an independent cardiovascular risk in normotensive individuals, irrespective of left ventricular mass (LVM).
  • These findings highlight the importance of monitoring nocturnal BP patterns for cardiovascular risk assessment in normotensive populations.
Abstract

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