Noctural dipping status and left ventricular hypertrophy: A cardiac magnetic resonance imaging study

Rodrigues, Jonathan; Amadu, Antonio Matteo; Harries, Iwan; Burchell, Amy E; Ratcliffe, Laura E K; Hart, Emma C J; Hamilton, M.C.K.; Paton, Julian F. R.; Nightingale, Angus K; Manghat, Nathan

doi:10.1111/jch.13235

Cited by 14 publications

(4 citation statements)

References 36 publications

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“…Palatini, in a study involving more than 10,000 adults, showed that extreme dipping is a risk factor for cardiovascular complications, but only in patients over the age of 70 [4]. Interestingly, recently extreme dippers were found to have an increased risk for left ventricular hypertrophy [49,50]. Our results indicate that excessive nocturnal blood pressure drop might also be associated with adverse arterial changes.…”

Section: Discussionmentioning

confidence: 53%

Circadian Blood Pressure Profile in Pediatric Patients with Primary Hypertension

Szyszka

Skrzypczyk

Ofiara

et al. 2022

JCM

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Our study aimed to evaluate factors affecting circadian BP profile and its association with hypertension-mediated organ damage (HMOD) in pediatric patients with primary hypertension (PH). The study included 112 children (14.7 ± 2.1 age, 79 boys, 33 girls) with untreated PH. Non-dipping was defined as a nocturnal drop in systolic or diastolic BP (SBP, DBP) < 10%, and a nocturnal drop >20% was defined as extreme dipping. The nocturnal SBP drop was 10.9 ± 5.9 (%), and the DBP drop was 16.2 ± 8.5 (%). Non-dipping was found in 50 (44.6%) children and extreme dipping in 29 (25.9%) patients. The nocturnal SBP decrease correlated with BMI Z-score (r = −0.242, p = 0.010) and left ventricular mass index (LVMI) (r = −0.395, p = 0.006); diastolic DBP decrease correlated with augmentation index (AIx75HR) (r = 0.367, p = 0.003). Patients with a disturbed blood pressure profile had the highest LVMI (p = 0.049), while extreme dippers had the highest augmentation index (AIx75HR) (p = 0.027). Elevated systolic and diastolic BP dipping were risk factors for positive AIx75HR (OR 1.122 95CI (1.009–1.249) and OR 1.095 95CI (1.017–1.177). We concluded that disturbed circadian BP profile was common in children with PH and should not be considered a marker of secondary hypertension. A disturbed circadian BP profile may be associated with higher body weight. In pediatric patients with PH, non-dipping is associated with increased left ventricular mass, and extreme dipping may be a risk factor for increased arterial stiffness.

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Section: Discussionmentioning

confidence: 53%

Circadian Blood Pressure Profile in Pediatric Patients with Primary Hypertension

Szyszka

Skrzypczyk

Ofiara

et al. 2022

JCM

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“…Blunted nocturnal BP dipping is associated with adverse cardiovascular outcomes independent of BP level (9,34). Both the BP non-dipping pattern and the nocturnal hypertension have been reported to correlate with not only LV structural and functional remodeling (6,15,(35)(36)(37), but also LA enlargement and phasic dysfunction (16)(17)(18). In the current study, consistent with the results of previous studies, non-dipping pattern of BP was related with more severe LV hypertrophy and reduced LV systolic function.…”

Section: Discussionmentioning

confidence: 99%

Association of Nighttime Systolic Blood Pressure With Left Atrial-Left Ventricular–Arterial Coupling in Hypertension

Sun

Zhao

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveHypertension (HT) induces left atrial (LA) and left ventricular (LV) dysfunction, and an increase in arterial stiffness. In this study, we investigated the association between LA-LV–arterial coupling and nighttime systolic blood pressure (BP) as well as BP circadian rhythm in essential hypertension.MethodsWe enrolled 290 HT patients. All subjects were evaluated by 2- dimensional speckle tracking echocardiography (2DSTE), ambulatory 24 h BP monitoring (ABPM), and brachial–ankle pulse wave velocity (PWV). According to BP patterns, these patients were divided into two groups, which included dippers (n = 111), patients with a >10% reduction in BP at nighttime; non-dippers (n = 179), patients with a <10% reduction in BP at nighttime. 2D-STE based LA and LV strains were studied and the following parameters were measured, LV global longitudinal strain (GLS), LA reservoir strain (LAS−S), LA conduit strain (LAS−E), and LA booster pump strain (LAS−A). LA stiffness index (LASI) defined as the ratio of E/e′ to LAS−S, and PWV-to-GLS ratio (PWV/GLS) were calculated to reflect LA-LV–arterial coupling. Furthermore, we also explored the correlation between LASI (or PWV/GLS) and ambulatory blood pressure indexes.ResultsLeft atrial stiffness index was significantly higher in non-dippers [0.29 (0.21, 0.41)] than in dippers [0.26 (0.21, 0.33)] (P < 0.05). PWV/GLS was significantly higher in non-dippers [−80.9 (−69.3, −101.5)] than in dippers [−74.2 (−60.2, −90.6)] (P < 0.05). LAS−S, LAS−E, LAS−A,and LV GLS were significantly lower in non-dippers than in dippers (P < 0.05). Multivariate linear regression analysis revealed that nighttime systolic BP was independently correlated with LASI and PWV/GLS, even adjusted for multiple clinical risk factors, LVMI, and LVEF.ConclusionsThe dipping pattern of BP was related to the abnormalities of myocardial mechanics and LA-LV–arterial coupling. However, absolute nocturnal systolic BP value maybe more important than BP circadian profile in the progression of abnormal LA-LV–arterial coupling.

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“…Furthermore, reverse dipping pattern has been previously associated with obstructive sleep apnoea, which also portends an increased cardiovascular risk (23). In particular, reverse dippers with essential hypertension have been found to have more advanced hypertension-mediated organ damage (24)(25)(26)(27)(28)(29). Therefore, patients with hypertension who have the reverse dipping pattern are at the highest risk of target organ damage and consequent complications.…”

Section: Discussionmentioning

confidence: 99%

Association between blood pressure dipping patterns and hypertension-mediated organ damage among Nigerians with newlydiagnosed hypertension

Dele-Ojo¹,

Ogunmodede²,

Ojo³

et al. 2021

REJHS

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Introduction: Abnormal blood pressure (BP) dipping patterns are associated with increased cardiovascular risk among Africans. This study determined the association between BP dipping patterns and hypertension-mediated organ damage among patients with newly-diagnosed hypertension.Methods: Ambulatory BP monitoring and echocardiography were carried out on 120 participants. Participants were categorized based on the ratio of night-time to day-time systolic BP into 4 patterns: Normal dipper (≥ 10% but < 20%), non-dippers (≥ 0% but < 10%), reverse dippers (<0%) and extreme dippers (≥ 20%).Result: Fifty-one (42.5%) were males, the mean age and body mass index were 44.2±9.8years and 27.1±4.4kg/m2 respectively. The non-dipping pattern was the most prevalent while the reverse dipping had the lowest mitral E/A ratio. Office systolic blood pressure was the only predictor of left ventricular hypertrophy (OR=1.050, 95% CI=1.004-1.098; p-value = 0.034).Conclusions: The non-dipping pattern was the most prevalent abnormal dipping pattern while the reverse dippers had the highest risk of hypertension-mediated organ damage. Office blood pressure was the only predictor of left ventricular hypertrophy. Hence, office BP measurement as well as ambulatory blood pressure measurements are potentially important tools in risk stratification in resource-poor settings of sub-Saharan Africa.

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Noctural dipping status and left ventricular hypertrophy: A cardiac magnetic resonance imaging study

Cited by 14 publications

References 36 publications

Circadian Blood Pressure Profile in Pediatric Patients with Primary Hypertension

Circadian Blood Pressure Profile in Pediatric Patients with Primary Hypertension

Association of Nighttime Systolic Blood Pressure With Left Atrial-Left Ventricular–Arterial Coupling in Hypertension

Association between blood pressure dipping patterns and hypertension-mediated organ damage among Nigerians with newlydiagnosed hypertension

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