Reverse Dipper Blood Pressure Pattern Influences More On Left Ventricular Functions In Elderly Systolic Hypertensive Patients

ObjectiveThe aim of this study is to investigate the effects of non-dipper and reverse dipper blood pressure patterns on the cardiac structure and function in elderly systolic hypertensive patients.Methods94 elderly systolic hypertensive patients were evaluated with echocardiography and ambulatory 24-hour blood pressure monitoring,84 patients with non-dipper blood pressure pattern and reverse dipper blood pressure pattern are included into our further research. Tissue Doppler-derived systolic and diastolic parameters were compared between non-dipper group and reverse dipper group. All the patients received fixed antihypertensive drug therapy for at least 3 months prior to the evaluation. ResultsAbnormal blood pressure patterns were found in 93% elderly systolic hypertensive patients, including 55 non dipper blood pressure patterns (58%) and 22 reverse blood pressure patterns (35%). Compared with non-dipper blood pressure pattern, reverse dipper patients had significant difference for aortic diameter(mm) (31.36±5.12, 26.57±4.49),left ventricular septum thickness(mm) (11.21±2.50,9.66±1.13),left ventricular posterior wall thickness(mm) (9.76±1.41,9.02±1.02),stroke volume(ml) (45.05±17.36,61.10±16.24) (p<0.01). There is difference between reverse dipper group and non-dipper group for ejection fraction (%)(46.26±12.66,55.21±10.53),left ventricular mass(g)(224.89±43.32,192.72±61.02),left ventricular mass index(g/m2) (124.13±22.54,105.39±32.62)ConclusionBlood pressure rhythm is one of the most important effect factors on target organ in elderly systolic hypertensive patients. Reverse dipper blood pressure patterns influence more on left ventricular structure and functions than non-dipper group.