Turk Kardiyol Dern Ars. 2008; 36(5): 310-317

Comparison of the incidences of left ventricular hypertrophy, left ventricular diastolic dysfunction, and arrhythmia between patients with dipper and non-dipper hypertension

Zeynep Demet Ersoylu¹, Aylin Tuğcu², Özlem Yıldırımtürk², Vedat Aytekin³, Saide Aytekin^3
1Bursa Heart and Arrhythmia Hospital
²Florence Nightingale Hospital, Cardiology Department
³T.c. Istanbul Bilim University, Cardiology Department, Florence Nightingale Hospital

OBJECTIVES
We compared the incidences of left ventricular hypertrophy (LVH), left ventricular diastolic dysfunction (LVDD), and arrhythmia in patients with dipper (DHT) and non-dipper (NDHT) hypertension.

STUDY DESIGN
Seventy-eight patients with essential hypertension were evaluated in two groups according to the results of 24-hour ambulatory blood pressure monitoring. Compared to daytime values, those whose nighttime blood pressure decreased ≥10% were defined as dippers (n=44, 35 females, 9 males; mean age 59±8 years), and those whose blood pressure decreased <10% were defined as non-dippers (n=34, 28 females, 6 males; mean age 58±8 years). The two groups were compared with respect to blood pressure levels, echocardiographic findings, and rhythm disturbances on 24-hour Holter monitoring.

RESULTS
Patients with NDHT exhibited significantly higher incidences of LVH (p=0.03) and LVDD (p=0.003). Aortic root diameter (p=0.001), end-diastolic thicknesses of the interventricular septum (p=0.002) and left ventricular posterior wall (p=0.03) were also significantly increased in this group. On 24-hour Holter monitoring, the number of patients with ventricular premature beat (VPB) (p=0.03), the total number of VPBs (p=0.03), and the number of VPBs per hour (p=0.001) were significantly greater in the NDHT group.

CONCLUSION
Our results suggest that, due to increased incidences of LVH, LVDD, and VPB, patients with NDHT should be further assessed with regard to increased risk for cardiovascular mortality and morbidity.

Keywords: Arrhythmias, cardiac, blood pressure monitoring, ambulatory; cardiac complexes, premature; circadian rhythm; echocardiography; hypertension; hypertrophy, left ventricular; ventricular function, left.

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