Clinical and Demographic Characteristics of Dipper and Non-Dipper Hypertensive Patients at Moderate Altitude

OBJECTIVE
Hypertension (HT) is a complex clinical syndrome linked to lifestyle, genetics, mental stress, and environmental factors. High-altitude (H-ALT) is one environmental factor that affects the development of HT. This study aimed to analyze the clinical and demographic features of patients residing at moderate altitude (M-ALT).


METHOD
A total of 515 patients with hypertension, confirmed through 24-hour ambulatory BP monitoring (ABPM), were screened. After exclusions, the final study population consisted of 452 patients. The participants were divided into two groups: dippers and non-dippers.


RESULTS
Patients in the Non-dipper group were older (SD: 61 ± 13 vs. 54 ± 12 years, p < 0.001) and had a significantly higher waist circumference (SD: 104 ± 13 vs. 107 ± 12 cm, p = 0.022). However, patients in the Dipper group had a significantly higher daytime mean SBP (SD: 144 ± 16 vs. 141 ± 17 mm Hg, p = 0.027) and daytime mean DBP (SD: 89 ± 12 vs. 87 ± 13 mm Hg, p = 0.037). Patients in the Non-dipper group also had a significantly higher ratio of abnormal Left ventricular global longitudinal strain (LVGLS) (n: 218 (65.6%) vs. n: 53 (46.7%), p = 0.009).


CONCLUSION
In our study, patients with a non-dipper pattern of hypertension, which is associated with poor multisystemic outcomes, were found to have a higher waist circumference and subclinical left ventricular dysfunction (abnormal LVGLS). Furthermore, patients with a non-dipper pattern of hypertension made up 76% of the study population.