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KMID : 0368120110410040191
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Korean Circulation Journal
2011 Volume.41 No. 4 p.191 ~ p.197
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Non-Dipper Pattern is a Determinant of the Inappropriateness of Left Ventricular Mass in Essential Hypertensive Patients
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Kim Bae-Keun
Lim Young-Hyo
Lee Hyung-Tak
Lee Jae-Ung
Kim Kyung-Soo
Kim Soon-Gil
Kim Jeong-Hyun
Lim Heon-Kil
Shin Jin-Ho
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Abstract
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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 (β=0.097, p=0.043) and nocturnal dipping (β=-0.098, p=0.046) were independent determinants of OPR as well as age (β=0.130, p=0.025) and body mass index (BMI) (β=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.
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KEYWORD
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Hypertension, Hypertrophy, left ventricular, Blood pressure monitoring, ambulatory
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