Cardiac arrhythmias and left ventricular hypertrophy in dipper and nondipper patients with essential hypertension.
To evaluate the behavior of cardiac arrhythmias in dipper and nondipper hypertensive patients, 48-h ambulatory blood pressure monitoring, 24-h Holter electrocardiogram recording and echocardiographic studies were performed in 56 untreated outpatients with essential hypertension. These patients were divided into 2 groups according to the presence (dipper, n=33) or absence (nondipper, n=23) of reduction of both systolic and diastolic blood pressure during nighttime by an average of more than 10% of daytime blood pressure. Mean 48-h systolic and diastolic blood pressures did not differ between the 2 groups. Nondipper patients had a significantly larger left atrial dimension (31.9+/-3.8 vs 35.6+/-3.7 mm; p<0.01), left ventricular mass index (114+/-26 vs 136+/-36 g/m2; p<0.05), as well as a larger number of total supraventricular (16+/-19 vs 89+/-197 beats; p<0.05) and ventricular ectopic beats (7+/-14 vs 47+/-96 beats; p<0.05) during daytime as compared with dippers. In conclusion, nondipper hypertensive patients are likely to experience supraventricular and ventricular arrhythmias more frequently than dippers. A blunted nocturnal blood pressure fall may be involved in the appearance of cardiac arrhythmias in patients with essential hypertension.
Second Department of Medicine, Yamanashi Medical University, Nakakoma, Japan. hijiri@res.yamanashi-med.ac.jp
H
H
Ijiri
I
I
Kohno
D
D
Yin
H
H
Iwasaki
M
M
Takusagawa
T
T
Iida
M
M
Osada
K
K
Umetani
T
T
Ishihara
T
T
Sawanobori
H
H
Ishii
S
S
Komori
K
K
Tamura
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology*; D018660:Blood Pressure Monitoring, Ambulatory; D005117:Cardiac Complexes, Premature / Q000175:diagnosis / Q000209:etiology; D002940:Circadian Rhythm; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000209:etiology