Does a nondipping pattern impact the right ventricle in hypertensive patients?

The purpose of this study was to determine the influence of a nondipping arterial blood pressure pattern on the right ventricular (RV) structure, diastolic, and global function in recently diagnosed hypertensive patients.

This cross-sectional study included 189 recently diagnosed hypertensive patients. All participants underwent 24 h ambulatory blood pressure monitoring and a complete two-dimensional echocardiography examination. We determined the ratio of early diastolic transtricuspid and septal areas of the tricuspid annulus flow velocities (E/e')t, as well as appropriate time intervals for the estimation of the Tei index. RV hypertrophy was defined by RV wall thickness of at least 6.0 mm in men and at least 5.5 mm in women.

The dipping blood pressure pattern was found in 107 (57%) participants, whereas the nondipping pattern was present in 82 (43%) hypertensive patients. The RV wall thickness as well as the (E/e')t ratio (5.12 ± 1.03 vs. 5.81 ± 1.12, P < 0.001) and the RV Tei index (0.42 ± 0.08 vs. 0.48 ± 0.11, P < 0.001) were increased in the nondippers (4.2 ± 0.84 vs. 4.7 ± 0.87 mm, P < 0.001). Analyses revealed that 24 h, daytime, and night-time systolic blood pressure, the nondipping status, and the left ventricular mass index were independently associated with RV wall thickness (P < 0.001 for all). The same parameters, along with RV wall thickness, were identified as independent predictors of RV diastolic function [(E/e')t] and RV global function (RV Tei index), respectively.

RV structure, diastolic, and global functions were significantly impaired in nondipper hypertensive patients. A nondipping blood pressure pattern represents one of the independent predictors of RV diastolic and global function as well as RV hypertrophy.