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Diastolic Reverse Dipping Pattern Is the Predictor for the Echocardiographic Changes in the Untreated Masked
Jianhao Li1, Yalin Cao2, Chen Liu3,4
1Department of Cardiology, Central Hospital of Panyu District, Guangzhou, China.
Insights
Diastolic blood pressure dipping patterns predict echocardiographic changes in untreated masked hypertension. Specific patterns like reverse and extreme dipping are linked to variations in heart structure, highlighting their prognostic value.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Imaging
Background:
- The prognostic implications of diastolic blood pressure (DBP) dipping categories remain unclear.
- Masked hypertension (MH) is associated with cardiovascular risks, but its link to specific DBP dipping patterns and cardiac structural changes is not well-defined.
Purpose of the Study:
- To investigate the association between diastolic blood pressure dipping categories and echocardiographic alterations.
- To identify potential predictive factors for cardiac changes in untreated masked hypertension patients.
Main Methods:
- Retrospective analysis of 721 untreated masked hypertension patients.
- Classification of nocturnal dipping categories based on percentage decrease in nocturnal blood pressure (BP) compared to daytime BP.
- Analysis of echocardiographic parameters including left atrium dimension, interventricular septum thickness, left ventricular end-diastolic dimension, and left ventricular mass.
Main Results:
- Significant differences in echocardiographic parameters were observed across the four DBP dipping categories.
- DBP reverse dipping was associated with increased interventricular septum thickness and left ventricular mass.
- DBP extreme dipping was linked to a lower left ventricular end-diastolic dimension.
- Nocturnal systolic hypertension correlated with increased left atrium dimension, interventricular septum thickness, and left ventricular mass.
Conclusions:
- Specific diastolic blood pressure dipping categories are predictive of echocardiographic changes in untreated masked hypertension.
- Nocturnal systolic hypertension also serves as a predictor for these cardiac structural alterations.
- These findings underscore the prognostic value of DBP dipping patterns in managing masked hypertension.
Background:
The prognostic value of the dipping categories of diastolic blood pressure (DBP) is unknown. This study aimed to investigate the association between DBP dipping categories of diastolic blood pressure and echocardiographic changes in untreated masked hypertension (MH) patients.
Methods:
This retrospective study included 721 untreated MH patients between June 2006 and June 2016. Nocturnal dipping categories were defined according to the percentage decrease in nocturnal blood pressure (BP) compared to daytime BP as follows: non-dipping: decrease 0% to <10%, dipping: decrease 10% to 20%, reverse dipping: decrease <0%, and extreme dipping: decrease >20%. The echocardiographic findings were analyzed.
Results:
The 4 echocardiographic parameters (left atrium [LA] dimension, interventricular septum [IVS] thickness, linear left ventricular end-diastolic dimension [LVEDD], and left ventricular [LV] mass) were significantly different among the 4 DBP dipping categories. Multivariate linear regression analysis showed that DBP reverse dipping pattern was associated with higher IVS thickness (B: 0.53, 95% CI: 0.24 to 0.82; P < 0.001) and LV mass (B: 12.36, 95% CI: 2.38 to 22.35; P = 0.015), whereas DBP extreme dipping was associated with lower LVEDD (B: -7.05, 95% CI: -11.30 to -2.80; P = 0.001).The nocturnal systolic hypertension was associated with higher IVS thickness (B: 0.42, 95% CI: 0.14 to 0.71; P = 0.003) and LV mass (B:14.21, 95% CI: 4.54 to 23.88; P = 0.004). The nocturnal systolic blood pressure was associated with LA dimension, IVS thickness, left ventricular posterior wall thickness, and LV mass (all Ps < 0.05).
Conclusions:
These results suggest that specific DBP dipping categories and nocturnal systolic hypertension were the predictive factors for the echocardiographic changes in untreated MH patients.
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