Left ventricular function, cardiac dysrhythmias, atrial activation, and volumes in nondipper hypertensive individuals with left ventricular hypertrophy

Rizzo, Vito; Maio, F. Di; Campbell, S. Villatico; Tallarico, Demetrio; Petretto, F.; Lorido, Antonio; Bianchi, A; Goubadia, Isaac Villatico; Carmenini, G

doi:10.1067/mhj.2000.103230

Cited by 9 publications

(14 citation statements)

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“…Previous studies have demonstrated that dipping status is an important predictor of LVH [7][8][9][10][11] -why then was this effect not evident in the present analysis? The critical factor may relate to the confounding effect of antihypertensive drug therapy.…”

contrasting

confidence: 56%

Ambulatory blood pressure monitoring and dipping status in predicting left ventricular hypertrophy

Narayan

Cameron

2014

Journal of Hypertension

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contrasting

confidence: 56%

Ambulatory blood pressure monitoring and dipping status in predicting left ventricular hypertrophy

Narayan

Cameron

2014

Journal of Hypertension

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“…Posterior wall thickness > in nondippers (24 † ,31) Atrial/brain natriuretic peptide > in nondippers (58) Left ventricular ejection fraction ↓ in nondippers (49,58) Supraventricular/ventricular ectopies > in nondippers (49,59) QT dispersion/QTc interval > in nondippers (60,61) Systemic vascular resistance ↑ at night in nondippers (62) ↓ at night in dippers (62) Stroke index ↑ at night in nondippers (63) ↓ at night in dippers (63) Cardiac index less of a ↓ at night in nondippers (63) ↓ at night in dippers (63) Cardiac output No difference between nondippers and dippers (24,62) Pulse pressure less of a ↓ at night in nondippers (12,67) ↓ at night in dippers (12,67) Carotid artery intima-media > in nondippers (9,14 (46,(73)(74)(75) Lacunae > in nondippers (6,10) Periventricular hyperintensities > in nondippers (6,10) White matter lesions > in nondippers (76) Previous cerebrovascular event More nondipping in those with previous events (71) Cognitive impairment > in nondippers (79) Dementia > in nondippers (78,81) Memory ↓ in nondippers (82) Sensory motor speed ↓ in nondippers (82) Microalbuminuria > in nondippers (6,27,84,85) *Cardiovascular eve...…”

Section: Cardiac Structural Alterationsmentioning

confidence: 99%

“…There is evidence to suggest that nondippers are at increased risk of cardiac dysfunction. Nondippers have been found to have increased levels of cardiac natriuretic hormones (51,58), lower LV ejection fraction (49,58), more ectopic beats (49,59), prolonged QT dispersion (60) and a prolonged QTc interval (61).…”

Section: Cardiac Functional Alterationsmentioning

confidence: 99%

Night-time blood pressure patterns and target organ damage: A review

Routledge

McFetridge-Durdle

Dean

2007

Canadian Journal of Cardiology

119

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A mbulatory blood pressure monitoring (ABPM) is a noninvasive, automated portable technology that measures and records blood pressure (BP) over a 24 h period (1). This technique has allowed researchers and clinicians to measure the percentage of elevated BP readings, as well as 24 h BP loads and BP patterns (2). Consequently, it has been discovered that BP varies over 24 h in a diurnal manner, being higher during the day and lower at night (3). The normal variation in BP is characterized by a 10% to 20% reduction in BP from day to night (2). Individuals with this decline in night-time BP are known as 'dippers', and those who experience a blunted decline in night-time BP are known as 'nondippers' (4). Researchers have determined individuals to be nondippers on the basis of a less than 10% reduction in night-time systolic BP (SBP) (5-11), diastolic BP (DBP) (5) or both SBP and DBP measurements (12-31).The exact mechanisms of action responsible for nondipping are not fully understood. However, data suggest that nondippers have an increase in sympathetic nervous system activity (32,33) and a decrease in parasympathetic nervous system activity throughout the night (32,34). Nondipping is more commonly found among individuals with renal diseases, autonomic neuropathies, diabetes, sleep apnea, autonomic dysfunction, malignant hypertension and secondary hypertension (35,36). In addition, approximately 25% of individuals with essential hypertension have a nondipping BP profile (37).There is evidence to suggest that individuals who exhibit a nondipping BP profile are at higher risk of cardiac and extracardiac morbidity (38). Verdecchia et al (39) used data from the Progetto Ipertensione Umbria Monitoraggio Ambulatoriale (PIUMA) study to examine the morbidity and mortality rates of 715 essential hypertensive patients over a one-to 13-year BACKGROUND: Individuals who do not have a 10% to 20% reduction in blood pressure (BP) during the night are known as 'nondippers'. The cause of this nondipping phenomenon is not fully understood; however, there is a growing body of evidence linking a nondipping BP pattern with target organ damage. OBJECTIVE: To review the literature and present an overview of the target organ damage found to be associated with a nondipping BP pattern. METHODS: PubMed, CINAHL and Medscape searches of all available English language articles from 1986 to 2005 were performed. Search terms included 'BP nondipping', 'BP dipping' and 'target organ damage'. RESULTS: There is evidence to suggest that individuals with hypertension who exhibit a nondipping BP profile are at higher risk of cardiac and extracardiac morbidity and mortality. In particular, nondippers with essential hypertension have been found to have more advanced left ventricular hypertrophy, left ventricular mass and left ventricular mass index, carotid artery wall thickness, carotid artery atherosclerotic plaques, silent cerebral infarct, stroke, cognitive impairment and microalbuminuria. CONCLUSION: A better understanding of the importance of the cir...

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“…A downward trend in the prevalence of LVH was noticed in the last decades, which coincided with improved HT control (Priori et al, 2001). A lack of a relation between left ventricular mass and the occurrence of LVPs has been also reported by some authors (Panagides et al, 1990;Prisant et al, 1993;Rizzo et al, 2000). Experimentally, LVH delays ventricular conduction and prolongs action potential duration.…”

Section: Hypertension (Ht)mentioning

confidence: 84%

“…Alterations in ion channels due to hypertrophy were also mentioned as possible causes of QT interval prolongation in LVH (Hancock et al, 2009). LVPs were present in both dippers and nondippers, and the values were significantly lower in dippers for SA-QRS and LAS40, and nondipper pattern was not linked to a worse arrhythmogenic substrate (Rizzo et al, 2000). There is no study with power to show prognostic significance of LVPs in HT patients.…”

Section: Hypertension (Ht)mentioning

confidence: 88%