Non-Dipper Pattern is a Determinant of the Inappropriateness of Left Ventricular Mass in Essential Hypertensive Patients.
10.4070/kcj.2011.41.4.191
- Author:
Bae Keun KIM
1
;
Young Hyo LIM
;
Hyung Tak LEE
;
Jae Ung LEE
;
Kyung Soo KIM
;
Soon Gil KIM
;
Jeong Hyun KIM
;
Heon Kil LIM
;
Jinho SHIN
Author Information
1. Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. jhs2003@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Hypertension;
Hypertrophy, left ventricular;
Blood pressure monitoring, ambulatory
- MeSH:
Blood Pressure;
Blood Pressure Monitoring, Ambulatory;
Body Mass Index;
Echocardiography;
Humans;
Hypertension;
Hypertrophy, Left Ventricular;
Linear Models;
Obesity;
Odds Ratio;
Prognosis;
Retrospective Studies
- From:Korean Circulation Journal
2011;41(4):191-197
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Inappropriately high left ventricular mass (iLVM) is known to be related to cardiovascular prognosis. A non-dipper pattern has a greater mean left ventricular (LV) mass than the dipper pattern in hypertensive patients. However, the appropriateness of LV mass in dipper or non-dipper patterns has not been adequately investigated. The aim of this study was to define the relationship between nocturnal dipping and the appropriateness of LV mass. SUBJECTS AND METHODS: Using the ambulatory blood pressure monitoring (ABPM) database, the data of 361 patients who underwent ABPM and echocardiography was analyzed retrospectively. Appropriateness of LV mass was calculated as observed/predicted ratio of LV mass (OPR) using a Korean-specified equation. Nocturnal dipping was expressed as percent fall in systolic blood pressure (BP) during the night compared to the day. RESULTS: Daytime, nighttime and 24 hours BP in hypertensive patients was 140.4+/-14.8 mmHg, 143.7+/-15.2 mmHg and 129.4+/-20.0 mmHg, respectively. OPR was 106.3+/-19.9% and nocturnal dipping was 10.2+/-10.9 mmHg. In a multiple linear regression model, 24 hours systolic BP (beta=0.097, p=0.043) and nocturnal dipping (beta=-0.098, p=0.046) were independent determinants of OPR as well as age (beta=0.130, p=0.025) and body mass index (BMI) (beta=0.363, p<0.001). Odds ratio of the non-dipper pattern was 2.134 for iLVM (p=0.021) and 3.694 for obesity (p<0.001; BMI >25 kg/m2). CONCLUSION: The non-dipper pattern is independently associated with iLVM in hypertensive patients as well as obesity.
