Non-dippers are associated with adverse cardiac remodeling and dysfunction (R1).
BACKGROUND
Non-dippers are known to carry a high risk of cardiovascular complications due to higher cumulative 24-h pressure load over time. In this study, we hypothesized that non-dippers would be associated with adverse cardiac remodeling and left ventricular (LV) dysfunction in treated hypertensive patients.


METHODS
A total of 150 outpatients treated with antihypertensive drugs for at least 1 year were enrolled. The patients were classified as non-dippers if their daytime ambulatory systolic and diastolic BP did not decrease by at least 10% during the night. LV diastolic function was assessed by measuring mitral inflow velocity (E), early diastolic mitral annulus tissue velocity (E') and LV systolic function was assessed by measuring systolic tissue velocity (S'), longitudinal systolic strain and strain rate.


RESULTS
The Cornell voltage product, LA volume index and LV mass index was significantly higher in non-dippers. Early diastolic mitral annulus tissue velocity (E') was lower and E/E' was higher in non-dippers suggestive of diastolic dysfunction. Systolic tissue velocity (S'), systolic strain and strain rate were significantly lower in non-dippers suggestive of systolic dysfunction. The non-dipper status, controlled for age, sex and LV mass index showed significant correlation with E' (beta=-0.203, P=0.002), E/E' (beta=0.354, P<0.001), S' (beta=-0.231, P=0.002), strain (beta=-0.162, P=0.040) and strain rate (beta=-0.186, P=0.015).


CONCLUSIONS
This study showed the non-dippers in treated hypertensive patients were associated with adverse cardiac remodeling and early LV dysfunction. Further studies to demonstrate the long term prognostic significance of this finding is warranted.
Seo
Hye-Sun
HS
Division of Cardiology, Cardiovascular Center, Yonsei University College of Medicine Seoul, South Korea.
Kang
Tae Soo
TS
Park
Sungha
S
Choi
Eui Young
EY
Ko
Young-Guk
YG
Choi
Donghoon
D
Ha
Jongwon
J
Rim
Se-Joong
SJ
Chung
Namsik
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*; D020257:Ventricular Remodeling / Q000502:physiology*
D000959:Antihypertensive Agents