Abstract
BackgroundThe relationship between electrocardiographic evaluation and circadian blood pressure (BP) variation in young and middle-aged hypertensive patients remains unknown.MethodsA total of 171 hypertensive patients were included in the study. First, patients were divided into a young and middle-aged group and an elderly group. The two groups were then separately classified into three subgroups on the basis of circadian variation of BP as dippers, non-dippers and reverse-dippers. The electrocardiographic evaluation was calculated from 12-lead electrocardiography (ECG).ResultsQTc intervals were shortest in the dippers and longest in the reverse-dippers in the young and middle-aged group (QTc dipper: 416.53±18.37ms; non-dipper: 438.30±29.71ms; reverse-dipper: 444.93±25.47ms; for dipper vs non-dipper, and dipper vs reverse-dipper P<0.05). QTc interval was found to be an independent risk factor for the non-dipper BP pattern (Odds ratio 1.049; 95% CI 1.01-1.089; P=0.012) and reverse-dipper BP pattern (Odds ratio 1.051; 95% CI 1.007-1.098; P=0.023) in young and middle-aged hypertensive patients. No significant differences in other ECG parameters were found among the three subgroups in the young and middle-aged group.ConclusionOur study suggested that QTc interval might serve as a risk factor for non-dipper BP pattern and reverse-dipper BP pattern in young and middle-aged hypertensive patients.
Highlights
Hypertension, ranking among the most prevalent chronic diseases, causes health loss by itself, and acts as an independent risk factor for many other diseases, such as stroke, heart failure, renal failure and coronary artery disease [1]
QTc intervals were shortest in the dippers and longest in the reverse-dippers in the young and middle-aged group (QTc dipper: 416.53±18.37ms; non-dipper: 438.30±29.71ms; reverse-dipper: 444.93±25.47ms; for dipper vs non-dipper, and dipper vs reverse-dipper P
QTc interval was found to be an independent risk factor for the non-dipper blood pressure (BP) pattern (Odds ratio 1.049; 95% confidence interval (CI) 1.01-1.089; P=0.012) and reverse-dipper BP pattern (Odds ratio 1.051; 95% CI 1.007-1.098; P=0.023) in young and middle-aged hypertensive patients
Summary
Hypertension, ranking among the most prevalent chronic diseases, causes health loss by itself, and acts as an independent risk factor for many other diseases, such as stroke, heart failure, renal failure and coronary artery disease [1]. To prevent target organ damage and cardiovascular events, the latest hypertension guidelines recommend early, strict and all-day blood pressure control [2, 3]. Ambulatory blood pressure monitoring (ABPM) is increasingly used in clinical practice to analyze circadian BP variation, to detect nocturnal hypertension and to evaluate the efficacy of antihypertensive drugs [4]. Circadian BP variation is quantified through the diurnal/ nocturnal BP ratio. Studies have shown that blunted nocturnal blood pressure dipping is related to damage of end organs and to cardiovascular mortality [6, 7]. The relationship between electrocardiographic evaluation and circadian blood pressure (BP) variation in young and middle-aged hypertensive patients remains unknown
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