The effect of blood pressure rhythm on the left ventricular structure and function in elderly systolic hypertensive patients

Abstract

Objective: The aim of this study was to investigate the effects of blood pressure rhythm on the left ventricular structure and function in elderly systolic hypertensive patients. Methods: 94 elderly systolic hypertensive patients were evaluated by echocardiography and ambulatory 24-h blood pressure monitoring, and 84 patients with non-dipper blood pressure pattern and reverse dipper blood pressure pattern are included into our further research. All the patients received fixed antihypertensive drug therapy for at least 3 months prior to the evaluation. The systolic and diastolic parameters derived from the tissue Doppler examination were compared between non-dipper group and reverse dipper group. Results: Abnormal blood pressure rhythm was 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) (1.21±2.50, 9.66±1.13), left ventricular posterior wall thickness (mm) (9.76±1.41, 9.02±1.02), and stroke volume (ml) (45.05±17.36, 61.10±16.24) (P<0.01). There was a 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), and left ventricular mass index (g/m2) (124.13±22.54, 105.39±32.62). Conclusion: Blood 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.