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Impact of Reverse Dipper and Non-Dipper Blood Pressure Patterns on Myocardial Performance Index in Hypertensive
Adem Aktan1, Raif Kılıç1, Tuncay Güzel2
1Department of Cardiology, Mardin Artuklu University Faculty of Medicine, Mardin, Turkey.
Echocardiography (Mount Kisco, N.Y.)
|June 1, 2026
Summary
Hypertension patients with abnormal nocturnal blood pressure patterns, specifically reverse dipper and non-dipper, show increased myocardial performance index (MPI), indicating subclinical cardiac dysfunction.
Area of Science:
- Cardiology
- Hypertension Research
- Cardiac Physiology
Background:
- Abnormal nocturnal blood pressure patterns are linked to subclinical cardiac dysfunction in hypertension.
- The relationship between these patterns and the myocardial performance index (MPI) requires further definition.
Purpose of the Study:
- To investigate the association between nocturnal blood pressure dipping patterns and MPI in hypertensive patients.
- To determine if abnormal circadian blood pressure variations correlate with subclinical cardiac dysfunction.
Main Methods:
- Retrospective analysis of 196 hypertensive patients using 24-hour ambulatory blood pressure monitoring (ABPM).
- Classification of patients into dipper, non-dipper, and reverse dipper groups based on nocturnal systolic blood pressure variation.
- Comparison of echocardiographic parameters, including MPI, and multivariate linear regression analysis.
Main Results:
- The reverse dipper group exhibited the highest MPI values (p < 0.001).
- Both reverse dipper (B = 0.054, p < 0.001) and non-dipper (B = 0.023, p = 0.002) patterns were independently associated with elevated MPI.
- MPI demonstrated moderate predictive power for the reverse dipper pattern (AUC = 0.693).
Conclusions:
- Reverse dipper and non-dipper blood pressure patterns are significantly associated with increased MPI.
- This suggests a link between abnormal circadian blood pressure regulation and subclinical cardiac dysfunction in hypertension.
- Further prospective research is needed to establish the clinical significance of these findings.
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Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
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Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
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