Frontal QRS-T angle may predict reverse dipping pattern in masked hypertensives.

Area of Science:

• Cardiology
• Hypertension Research
• Electrocardiography

Background:

• The frontal QRS-T (fQRST) angle is a recognized indicator of adverse cardiovascular outcomes.
• Masked hypertension (MH) presents unique challenges in cardiovascular risk assessment.
• Understanding the relationship between nocturnal blood pressure patterns and cardiac electrical activity is crucial.

Purpose of the Study:

• To investigate the association between the reverse dipping blood pressure pattern and the fQRST angle in patients with newly diagnosed masked hypertension.
• To determine if the fQRST angle can serve as a predictive marker for the reverse dipping pattern in MH.

Main Methods:

• A cohort of 244 newly diagnosed masked hypertensive patients was analyzed.
• Patients were categorized into dipper, non-dipper, and reverse dipper groups based on their 24-hour ambulatory blood pressure monitoring.
• The fQRST angle, QT interval, corrected QT interval, and QT dispersion were measured from 12-lead surface electrocardiograms.

Main Results:

• The reverse dipper group exhibited a significantly higher fQRST angle compared to non-dipper and dipper groups (77.9 ± 8.6 vs. 32.4 ± 18.8 and 26.0 ± 18.5, respectively; p < .001).
• A cutoff fQRST angle of 51 demonstrated high predictive value for the reverse dipping pattern (Area Under the Curve: 0.84; 95% CI: 0.77-0.90), with 83% sensitivity and 78% specificity.

Conclusions:

• A progressive increase in the fQRST angle was observed from dipper to non-dipper and further to reverse dipper masked hypertensive patients.
• The fQRST angle emerges as a simple and effective tool for identifying and assessing cardiovascular risk in hypertensive individuals.