More exaggerated blood pressure morning surge is associated with more deteriorated cardiac function evaluated by 3-dimensional echocardiographic examination

Abstract

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): The Korean Society of Hypertension Background We studied the association between the exaggerated morning blood pressure (BP) surge and cardiac function evaluated by 3-dimensional echocardiography in naïve hypertensive patient. Methods and results We studied longitudinal, circumferential and principal strain as well as torsion in 163 naïve hypertensive patients in whom ambulatory BP monitoring was performed. The morning surge (MS) was calculated as mean systolic BP during the 2 hours after awakening minus mean systolic BP during 1 hour included the lowest sleep BP. Patients were divided into 2 groups (MS 25 percentile). There were no differences of left ventricular ejection fraction between the groups (MS: no MS, 62.0 ± 2.4: 62.2 ± 3.3, p = 0.807) but global longitudinal (MS: no MS, -21.2 ± 1.7: -22.0 ± 2.3, p = 0.072), circumferential (MS: no MS, -30.1 ± 2.0: -31.1 ± 2.7, p = 0.045), principal strain (MS: no MS, -33.9 ± 1.7: -35.5 ± 2.8, p < 0.001), twist(MS: no MS, 9.6 ± 6.1: 12.1 ± 4.8, p = 0.011) and torsion (MS: no MS, 1.23 ± 0.78: 1.49 ± 0.62, p = 0.042) were different between the groups. We also divided the groups into four according to the degree of morning surge and 4th quartile group showed more decreased cardiac functions. Conclusion Left ventricular mechanical parameters deteriorate from the very early stage of hypertension in the patients with morning surge. And it is more exaggerated in the higher morning blood pressure elevation group. Abstract Figure.