title: Not nondipping but nocturnal blood pressure predicts left ventricular hypertrophy in the essential hypertensive patients: the Korean Ambulatory Blood Pressure multicenter observational study.
abstract: OBJECTIVE
  The aim of this study was to investigate whether nocturnal blood pressure (BP), established on the basis of a single 24-h BP monitoring, is a stronger predictor of left ventricular hypertrophy (LVH) compared with nondipping status in the essential hypertensive patients.
  
  
  METHODS
  A total of 682 hypertensive patients (mean age 56.1 ± 14.5 years, 50.7% women) who underwent echocardiography were enrolled. 'Nondipping status' was defined as a nocturnal SBP fall less than 10% of daytime mean SBP. LVH was defined as a left ventricular mass index exceeding 54.0 g/m in men and 53.0 g/m in women. Each patient was categorized in three groups according to the total cardiovascular risk using 2007 European Society of Hypertension/ European Society of Cardiology guidelines as average or low, moderate, and high or very high added risk.
  
  
  RESULTS
  Among 682 participants, 184 (26.9%) showed LVH on echocardiography. The proportion of individuals with high or very high added cardiovascular risk profile was 356 (52.1%). In multiple logistic regression analysis, age 56 years at least [odds ratio (OR) 1.047, 95% confidence interval (CI) 1.031-1.063, P < 0.0001], female participants (OR 1.751, 95% CI 1.172-2.616, P = 0.0062), BMI higher than 24.6 kg/m (OR 1.178, 95% CI 1.110-1.250, P < 0.0001), smoking (OR 1.793, 95% CI 1.028-3.127, P = 0.0397), and nocturnal SBP at least 127 mmHg (OR 1.032, 95% CI 1.009-1.055, P = 0.0059) were significant independent predictors for LVH whereas nondipping was not (OR 0.857, 95% CI 0.481-1.528, P = 0.6013).
  
  
  CONCLUSIONS
  These findings suggest that nocturnal BP rather than nondipping may be a better predictor of LVH, especially in secondary or tertiary referral hospital setting targeting relatively high cardiovascular risk patients.
authors.affiliation: aDepartment of Internal Medicine, College of Medicine, Catholic University of Korea bDepartment of Internal Medicine, College of Medicine, Hanyang University, Seoul cDepartment of Internal Medicine, School of Medicine, Chonnam University, GwangJu dDepartment of Internal Medicine, School of Medicine, Yonsei University, Seoul eDepartment of Internal Medicine, School of Medicine, Seoul National University, Bundang fDepartment of Internal Medicine, School of Medicine Kyung Hee University gDepartment of Internal Medicine, School of Medicine, Ewha Womans University, Seoul hDepartment of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea *Jeong-Eun Yi and Jinho Shin contributed equally to the writing of this article.
authors.forename: Jeong-Eun
authors.initials: JE
authors.lastname: Yi
authors.forename: Jinho
authors.initials: J
authors.lastname: Shin
authors.forename: Sang-Hyun
authors.initials: SH
authors.lastname: Ihm
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Sungha
authors.initials: S
authors.lastname: Park
authors.forename: Kwang-il
authors.initials: KI
authors.lastname: Kim
authors.forename: Woo Shik
authors.initials: WS
authors.lastname: Kim
authors.forename: Wook Bum
authors.initials: WB
authors.lastname: Pyun
authors.forename: Yu-Mi
authors.initials: YM
authors.lastname: Kim
authors.forename: Soon Kil
authors.initials: SK
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D044466:Asian People; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D004452:Echocardiography; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D013997:Time Factors