Morning blood pressure surge and diastolic dysfunction in patients with masked hypertension.

Abstract

In this study, we evaluated the association between morning blood pressure surge (MBPS) levels and diastolic function parameters in patients with masked hypertension (MH). A total of 92 patients with diagnosis of MH were enrolled in the study. Patients were divided into three groups according to their MBPS levels. Cardiac dimensions, left atrial volume and ejection fraction were determined by transthoracic echocardiography. A two-dimensional Doppler echocardiogram was performed to evaluate diastolic function parameters including transmitral E-wave and A-wave velocity, mitral annular E' and A' velocity, E wave deceleration time and isovolumic relaxation time. Mean MBPS value of the total study population was 25.1 ± 6.4 mmHg. When going from the lowest MBPS group to the higher MBPS groups; E velocity [0.75 (0.74-0.77) vs. 0.71 (0.69-0.73) vs. 0.68 (0.66-0.69) cm/s, respectively] E/A ratio [1.44 (1.40-1.48) vs. 1.35 (1.32-1.39) vs. 1.26 (1.23-1.29), respectively] and E' velocity [0.114 (0.111-0.117) vs. 0.102 (0.100-0.105) vs. 0.093 (0.089-0.096) cm/s, respectively] were significantly decreased. E/E' ratio [7.3 (6.9-7.7) vs. 6.6 (6.4-7.9), P = 0.002] and left atrial volume index [27.24 (25.5-28.9) vs. 21.90 (21.0-22.7) ml/m, P < 0.001] were significantly higher in the highest MBPS tertile than the lowest tertile. There was a positive correlation between E/E' ratio and MBPS values (r = 0.306, P = 0.003). Increased MBPS levels were found to be related with deterioration of diastolic function parameters in patients with MH.