The association between frontal QRS-T angle and reverse dipper status in newly diagnosed hypertensive patients

The frontal QRS-T angle (fQRS-T angle) in ECG is a new measure of myocardial repolarization, in which a higher fQRS-T angle is linked with worse cardiac outcomes. Reverse dipper hypertension is also linked to poor cardiac outcomes. The purpose of this study was to investigate the association between the fQRS-T angle and reverse dipper status in individuals newly diagnosed with hypertension who did not have left ventricular hypertrophy (LVH). The investigation recruited 171 hypertensive individuals without LVH who underwent 24-h ambulatory blood pressure monitoring (ABPM). On the basis of the findings of 24-h ABPM, the study population was categorized into the following three groups: patients with dipper hypertension, non-dipper hypertension, and reverse dipper hypertension. LVH was defined by echocardiography. The fQRS-T angle was measured using the 12-lead ECG. The fQRS-T angle in individuals with reverse dipper hypertension was substantially greater than in patients with and without dipper hypertension (51° ± 28° vs. 28° ± 22° vs. 39° ± 25°, respectively, P < 0.001). The fQRS-T angle (odds ratio: 1.040, 95% confidence interval: 1.016-1.066; P = 0.001) was independently associated with reverse dipper hypertension according to multivariate analysis. In receiver operating characteristic curve analysis, the fQRS-T angle to predict reverse dipper hypertension was 33.5° with 76% sensitivity and 71% specificity. This study showed that an increased fQRS-T angle was associated with reverse dipper hypertension in newly diagnosed hypertensive patients without LVH.