Not nondipping but nocturnal blood pressure predicts left ventricular hypertrophy in the essential hypertensive patients

Abstract

These findings suggest that nocturnal BP rather than nondipping may be a better predictor of LVH, especially in secondary or tertiary referral hospital setting targeting relatively high cardiovascular risk patients.

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

“…This is highly pertinent to the hypothesis that dipping status per se is an important determinant of outcome and not the confounding influence of mean 24-h BP (which is often higher in nondippers). The principal finding of the Korean-Ambulatory Blood Pressure study [5], that nocturnal BP is a far more powerful determinant of LVH is, however, consistent with the previously published data [3,6]. Therefore, given this finding in a cohort of 9641 patients, it is not entirely surprising that dipping status failed to predict LVH in the analysis reported by Yi et al [5] in a substantially smaller cohort of patients.…”

“…Finally, in an analysis performed by the International Database of Ambulatory blood pressure in relation to Cardiovascular Outcome investigators, the night-to-day SBP ratio was only a weak predictor of fatal and nonfatal cardiovascular events and daytime BP was not predictive of the cardiovascular events in those patients receiving antihypertensive therapy [3]. In the present analysis, women only constituted 60% of the population with LVH, and a stratified analysis between the sexes was not performed [5]. In the present analysis, women only constituted 60% of the population with LVH, and a stratified analysis between the sexes was not performed [5].…”

“…Importantly in this analysis, dipping status was adjusted for the 24-h BP. Therefore, given this finding in a cohort of 9641 patients, it is not entirely surprising that dipping status failed to predict LVH in the analysis reported by Yi et al [5] in a substantially smaller cohort of patients. Despite being statistically significant, the night : day ratio only explained 0.1% of the estimated variance in this meta-analysis [2].…”

The Prognostic Value of Self‐Assessed Nocturnal Blood Pressure

“…Thus, one of the strongest arguments for ABPM over other techniques has been the ability to determine nocturnal asleep BP, which is particularly important for high‐risk patients such as those with diabetes or chronic kidney disease . A recent finding from the Korean Ambulatory Blood Pressure multicenter observational study suggests that the nocturnal BP level rather than the presence of nondipping predicts left ventricular hypertrophy . By contrast, analysis of the Spanish ABPM Registry suggests that nondipping is associated with more advanced disease .…”

Assessment of left atrial function: Another window to detect early cardiac impairment?

“…However, LA functional impairment is detected in patients who have normal LA size, which suggests that LA functional impairment may happen earlier than LA structural abnormality and may provide information of earlier cardiac impairment than LA size alterations do. Currently, it is possible to detect the early abnormalities of LA function that could not be previously measured by conventional assessments . Thus, assessment of LA function may be a new window to detect early cardiac impairment in the future, although large efforts and further investigations are warranted.…”