Non-dipper Hypertension Group Research Articles

The Relationship Between the Dipping Pattern and Coronary Artery Disease Severity Assessed by the SYNTAX Score in Patients With Hypertension.

Background The morbidity and mortality rates related to hypertension (HT) are still high despite the developments in this area. Nondipper hypertension (NDHT) is related to worse clinical outcomes. But the dipping pattern of HT is not still used for treatment targets. In this study, we investigated the effect of dipping patterns on coronary artery disease (CAD) complexity evaluated by the SYNTAX score (SS). Methodology Patients with stable CAD and HT were included in the study. All patients were monitored with 24-hour ambulatory monitoring, and dipping patterns were evaluated. Coronary artery complexity was determined by SS for all patients and compared along with different dipping patterns. Results A total of 331 patients with HT and stable CAD were evaluated in the study. The mean age of the patients was 62.6 ± 9.9 years, and 172 (52%) were male. The number and percentage of patients with dipper HT (DHT), NDHT, over-dipper HT (ODHT), and reverse-dipper HT (RDHT) were 89 (26%), 143 (43%), 11 (3%), and 88 (26%), respectively. When the groups were compared according to SS, the SS of the patients with RDHT were significantly higher (the SS were 6.33, 4.99, 3.09, and 2.7 for RDHT, ODHT, NDHT, and DHT, respectively, P = 0.003). The mean SS between the DHT group and the NDHT group (P = 0.03) and between the DHT group and the RDHT group (P = 0.01) was significantly different. The less decrease or increase in mean blood pressure (MnBP) values was significantly correlated with high SS. Conclusions NDHT, especially the reverse dipping pattern, is closely related to complex CAD. Meticulous consideration of dipping patterns can identify high-risk patients and improve clinical outcomes.

Systemic Immune-Inflammation Index: A Novel Predictor for Non-dipper Hypertension.

IntroductionThe non-dipper hypertension (HT) pattern is associated with more end-organ damage and cardiovascular events than is dipper HT. Inflammation is widely established to play a role in the pathophysiology of HT. Recently, a new inflammatory and prognostic marker called the systemic immune-inflammation index (SII) has emerged. Our goal is to determine whether there is a relationship between non-dipper HT and SII.MethodsOur study is a single-center retrospective and ninety-one patients with HT were included. All patients were analyzed with simultaneous 24-hour ambulatory blood pressure monitoring and laboratory parameters. Thirty-five patients had dipper HT while 56 patients had non-dipper HT. SII was calculated according to neutrophil, platelet, and lymphocyte counts.ResultsThe median age was 48 (45-61 interquartile range (IQR)) in the non-dipper HT group, whereas it was 54 (44-64 IQR) in the dipper HT group. Although the neutrophil level, neutrophil-lymphocyte ratio, platelet lymphocyte ratio, SII, sleeping systolic blood pressure (BP), and sleeping diastolic BP were higher (p=0.020, p=0.041, p=0.046, p=0.019, p<0.001, and p=0.001, respectively) in the non-dipper HT group, the lymphocyte level was lower (p=0.040). A multivariate logistic regression model shows that SII (odds ratio (OR)=1.023, 95% confidence interval (CI)=1.002-1.112, p=0.012) may be an independent predictor of non-dipper HT.ConclusionOur study showed that the SII level was higher in the non-dipper HT patient group than in the dipper HT group. Furthermore, SII was an independent predictor of non-dipper HT. The high SII value in hypertension patients can be used as an early warning parameter to identify non-dipper HT patients.

Assessment of salusin alpha and salusin beta levels in patients with newly diagnosed dipper and non-dipper hypertension

ABSTRACT Objective The pathophysiology of non-dipper hypertension has not been clarified. The relationship between salusins with atherosclerosis and hypertension has gained attention in recent years. The aim of this paper is to investigate whether salusins are associated with circadian blood pressure, left ventricular mass index, and diastolic functions in newly diagnosed hypertensives. Methods The study included 88 newly diagnosed hypertensive individuals. Twenty-four-hour ambulatory blood pressure monitoring and echocardiographic examinations were performed. The patients were assigned to dipper hypertension (n = 41) and non-dipper hypertension (n = 47) groups based on the ambulatory blood pressure monitoring results according to the presence of ≥ a 10% decrease in nighttime blood pressure values or not. Serum salusin α and β levels were determined by electrochemiluminescence immunological test method. Results Compared to dipper hypertension, non-dipper hypertension group demonstrated lower salusin α levels (1818.71 ± 221.67 vs 1963 ± 200.75 pg/mL, p = .002), mitral E/A, septal E’/A’ and higher salusin β levels (576.24 ± 68.15 vs 516.13 ± 90.7 pg/ml, p = .001) and left ventricular mass index. Multivariate logistic regression analysis revealed salusin-α (OR 0.474, 95% CI 0.262 to 0.986, p = .001), salusin-β (OR 2.550, 95% CI 2.123 to 2.991, p = .018), and left ventricular mass index (OR 2.620, 95% CI 2.124 to 2.860, p = .011) as independent predictors of non-dipper hypertension. As candidate markers to predict non-dipper hypertension, decreased salusin α, and increased salusin β levels may mediate crosstalk between sympathetic and parasympathetic systems and indicate poor cardiovascular prognosis in hypertension.

Association between Growth Differentiation Factor 15 and Non-Dipping Circadian Pattern in Patients with Newly Diagnosed Essential Hypertension

Objective: Non-dipper hypertension (HT) confers greater risk compared with dipper HT. Growth differentiation factor 15 (GDF-15) recently emerged as a novel and independent marker of cardiovascular disease, both in diagnostic and prognostic scopes. Our aim was to evaluate the relationship of circadian blood pressure (BP) pattern with serum GDF-15 level in newly diagnosed HT patients without left ventricular hypertrophy. Subjects and Methods: Newly diagnosed non-dipper (n = 66) and dipper (n = 60) HT patients were selected according to 24-h ambulatory BP monitoring (ABPM). The controls comprised healthy normotensive subjects (n = 31). Data was collected through physical examination, laboratory analysis, ABPM, and echocardiography. GDF-15 was measured using ELISA. Results: Greater GDF-15 level was found in the non-dippers compared with the dippers and the controls (557.53 ± 91.7, 513.79 ± 62.86, and 494.44 ± 79.30 ng/L, respectively, p < 0.001). In bivariate linear correlation analysis, GDF-15 correlated positively with glomerular filtration rate (r = 0.180, p =0.030), total cholesterol (r = 0.170, p = 0.038), septal E/E′ ratio (r = 0.344, p = 0.001), lateral E/E′ ratio (r = 0.366, p < 0.001), nighttime systolic BP (r = 0.166, p = 0.046), and nighttime diastolic BP (r = 0.188, p = 0.024); however, it correlated negatively with septal and lateral E′ velocities (r = 0.268, p = 0.005 and r = 0.236, p = 0.013, respectively). Furthermore, GDF-15 level and nighttime diastolic BP remained independently associated with non-dipper HT. In ROC analysis, optimal cutoff value for GDF-15 was 524.6 ng/L with 56.7% sensitivity and 72.4% specificity (AUC: 0.676, 95% CI: 0.580–0.772, p < 0.05). Conclusion: Our results showed GDF-15 upregulation in the non-dipper HT group. GDF-15 and nighttime diastolic BP were independently associated with the non-dipping pattern. This study may suggest possible utilization of GDF-15 in the prediction of non-dipper HT.

The effect of birth season on diurnal variation of blood pressure in hypertensive patients

Background. Birth season has been found to be related to cardiovascular disorders, but the underlying mechanisms are unclear. The aim of this study was to evaluate the relationship between birth season and diurnal variation in blood pressure (BP) parameters in hypertensive patients. Material and methods. We enrolled 194 patients. The date of birth was recorded with the season of birth determined as winter (December-February), spring (March-May), summer (June-August) or autumn (September-November). All patients underwent 24-hour ambulatory blood pressure monitoring (ABPM) for evaluation of dipper or non-dipper status. We searched for the relationship between birth season and non-dipper status and other ABPM parameters. Results. 93 patients were classified into the dipper hypertensive group and 101 patients were in the non-dipper hypertensive group. We did not find any association between non-dipper status and birth season in hypertensive patients (p = 0.517). However, we found a significant relationship between diurnal variation in BP and birth season. This difference was observed between winter and spring season. We found a significant relationship between birth season and 24-hour diastolic BP, awake diastolic BP, sleep diastolic BP and sleep mean BP (p = 0.035, p = 0.037, p = 0.036, p = 0.032, respectively). These ABPM parameters were lower in patients born in winter than in those born in spring. Conclusion. Birth season was found to be related to diurnal variation in blood pressure in hypertensive patients. Hypertensive individuals born in winter had lower blood pressure than those born in spring.

Discerning the relationship between left ventricular geometry, high-sensitivity troponin T, and nondipper hypertension.

Hypertension can cause anatomic changes in the left ventricle, generally leading to abnormal geometry. High-sensitivity cardiac troponin T (hs-cTnT) values have been shown to be positively correlated with left ventricular hypertrophy in hypertensive patients. The current study investigated the diagnostic value of hs-cTnT in patient with nondipper hypertension (NDH) as well as determined the correlation between left ventricular geometric patterns and hs-cTnT values in hypertensive patients. A total of 100 consecutive patients (58 women and 42 men) who were referred to our clinic between 1 October 2015 and 1 March 2016 with elevated blood pressure (BP) were included. Of the patients, 63 had dipper hypertension [nocturnal decline in mean BP (≥10%)], whereas the remaining 37 had NDH [nocturnal decline in mean BP (<10%)]. Of note, hs-cTnT levels were measured only once during admission. Echocardiographic examinations were performed at baseline month and repeated at the sixth month. Hs-cTnT was significantly increased in those with NDH (P<0.001). The NDH group experienced significant decreases in concentric hypertrophy pattern over 6 months (P=0.014). Hs-cTnT was significantly related with nondipping status (r=0.747, P<0.001). Hs-cTnT was also an independent predictor of NDH (odds ratio=1.034, 95% confidence interval: 1.018-1049, P<0.001). Hs-cTnT value of more than 0.95 ng/l predicted NDH with a sensitivity of 75% and specificity of 98% (area under the curve: 0.86; 95% confidence interval: 0.782-0.925; P<0.001). Our current results indicate that patients with NDH had higher hs-cTnT levels than the patients with dipper hypertension. Hs-cTnT was an independent predictor of NDH and was significantly related with nondipping status. Hence, hs-cTnT may be used as diagnostic biomarker in NDH.

The relationship between echocardiographic epicardial adipose tissue thickness and non dipper hypertension

Objective To investigate the correlation between epicardial fat thickness and non dipper hypertension. Methods A total of 150 subjects was included in the study, of which 50 were in the non dipper hypertension group, the same in the non dipper hypertension group and the healthy control group. History collection and routine laboratory tests, ultrasonic measurement of epicardial fat thickness, and 24 hour ambulatory blood pressure monitoring were carried on all subjects. Epicardial fat thickness between groups was compared to primarily analyze the correlation of epicardial fat thickness and non dipper type hypertension. The optimal screening positive value in epicardial fat thickness of non dipper type primary hypertension was obtained by receiver operating characteristic (ROC) curve and maximum Youden index. Results When non dipper hypertension group and non-dipper hypertension group were compared, epicardial fat thickness was significantly increased [(6.30±0.94)mm vs (5.92±0.75) mm, P<0.05], as compared dipper hypertension group to healthy group, the epicardial fat thickness was significantly increased [(5.92±0.75)mm vs (5.50±0.13)mm, P<0.05]. Epicardial fat thickness and non dipper type primary hypertension were linearly related (r=0.43, P<0.05), and epicardial fat thickness in diagnosis of non dippers primary hypertension optimal screening positive value was 6.01 mm. Conclusions There is a close relationship of epicardial fat thickness and non dipper hypertension. Key words: Ultrasonography; Pericardium; Adipose tissue; Hypertension/PP

Assessment of mean platelet volume and soluble CD40 ligand levels in patients with non-dipper hypertension, dippers and normotensives

Objective: Patients with a lack of nocturnal decline in blood pressure (BP) are at an increased risk for cardiovascular events. Mean platelet volume (MPV) and soluble CD40 ligand (sCD40L) are accepted biomarkers of platelet activation and considered as a risk factor for cardiovascular disease. The aim of this study was to determine whether MPV and sCD40L levels are higher in non-dipper hypertensive (NDHT) patients than in dipper hypertensive (DHT) patients and healthy controls.Methods: 124 consecutive patients were included to this study. Patients were divided into three groups: NDHT patient group [n = 43; mean age 51.8 ± 6.6; 31 males (72.1%)]; DHT patient group [n = 41; mean age 50.2 ± 7.3; 22 males (53.7%)]; and normotensive group [n = 40; mean age 49.9 ± 6.7; 22 males (55%)]. Physical examination, laboratory work-up and 24-h ABPM were performed for all participants.Results: The sCD40L and MPV levels were significantly higher in the NDHT group than in the DHT and normotensive groups (p < 0.05). In correlation analysis, MPV, 24-h systolic blood pressure (SBP), 24-h diastolic blood pressure (DBP), night-time SBP and night-time DBP were positively correlated with sCD40L.Conclusion: Our study demonstrated that MPV and sCD40L levels were significantly higher in NDHT patients compared to DHT and normotensive patients. sCD40L levels were positively correlated with MPV, 24-h SBP, 24-h DBP, night-time SBP and night-time DBP.

Comparison of inflammatory markers in non-dipper hypertension vs. dipper hypertension and in normotensive individuals: uric acid, C-reactive protein and red blood cell distribution width readings.

AimIn this study, we investigated the relationship of increased inflammatory parameters (C-reactive protein – CRP), oxidative stress markers (serum uric acid – SUA) and red blood cell distribution width (RDW) with non-dipper hypertension (NDHT).Material and methodsAmong the individuals who presented to the cardiology clinic, 40 patients (32.5% male, 67.5% female; mean age: 54.4 ±7.1) who had hypertension and were diagnosed with NDHT through ambulatory blood pressure monitoring, 40 age- and sex-matched dipper hypertension (DHT) patients (25% male, 75% female, mean age: 54.2 ±7.0), and 40 normotensive individuals (42.5% male, 57.5% female, mean age: 51.9 ±9.0) were enrolled in the study. Peripheral venous blood samples were collected from all the patients in order to evaluate the hematological and biochemical parameters. All the assessed parameters were compared among the groups.ResultsThe CRP, RDW and uric acid levels were observed to be significantly higher in the non-dipper hypertension group in comparison to the dipper hypertension patients and the normotensive population (p < 0.05). These parameters were also significantly higher in the dipper HT group compared to the normotensive population (p < 0.05).ConclusionsWe found in our study that increased CRP, uric acid and RDW levels, which are indicators of increased inflammation and oxidative stress, are significantly higher in the non-dipper HT patients in comparison to the dipper HT patients and control group.

Serum Urotensin II Levels in Patients with Non-Dipper Hypertension

Hypertension terms “dipper” and “non-dipper” are propounded by the change that occurs during ambulatory blood pressure (BP) monitoring. The purpose of this study is to present whether the serum urotensin II levels are different in patients with dipper and non-dipper hypertension and to put forward the effects causing this difference, if there are any. Patients recently diagnosed with hypertension were included in the study. With ambulatory BP monitoring, 81 patients with high BP were divided into two groups, dipper (n = 40) and non-dipper (n = 41). Serum urotensin II levels were analyzed by ELISA method. Serum urotensin II levels were higher in patients with non-dipper hypertension than in patients with dipper hypertension (204 [106–533] vs. 140 [96–309], P = .004). There was a positive correlation between total systolic BP and serum urotensin II levels (r = 0.408 and P = .009), but the relation in the non-dipper hypertension group was not significant (r = 0.194 and P = .2). In conclusion, serum urotensin II levels were higher in non-dipper HT patients than dipper HT patients. This higher urotensin II level might be responsible for poor prognoses.

DNA damage and oxidative status in newly diagnosed, untreated, dipper and non-dipper hypertensive patients

DNA damage occurs more often in hypertensive patients than in non-hypertensive individuals. We sought to investigate lymphocyte DNA damage and total antioxidant status (TAS) levels in patients with dipper hypertension (DH) and non-dipper hypertension (NDH). Thirty-three patients with NDH (NDH group), 31 patients with DH (DH group) and 20 healthy volunteers (control group) were included in the study. Measurements from ambulatory blood pressure monitoring were obtained for all subjects. DNA damage was assessed in peripheral lymphocytes by comet assay, and plasma TAS levels were determined using an automated measurement method. The mean DNA damage value of the NDH group was higher than that of both the DH and control groups (P=0.002 and P<0.001, respectively). The mean DNA damage value of the DH group was higher than that of the control group (P<0.001). The mean TAS level of the NDH group was lower than that of both the DH and control groups (P=0.001 and P<0.001, respectively), and the mean TAS level of the DH group was lower than that of the control group (P<0.001). DNA damage was negatively associated with TAS level (r=-0.692, P<0.001) and positively associated with high sensitive c-reactive protein level (r=0.315, P=0.012). DNA damage increased in the NDH group compared with both the DH group and control group. This condition may be related to increased oxidative stress in the NDH group compared with the DH and control groups.

Evaluation of biochemical, hematological, and thyroid function parameters in nondipper and dipper hypertensive patients

In this study we investigated the effects of biochemical, hematologic, and thyroid function parameters on the circadian rhythm of hypertensive patients whose 24-h ambulatory blood pressure was being followed. We studied the fasting glucose, urea, creatinine, uric acid, aspartate transaminase, alanine aminotransferase, gamma-glutamyl transferase, total protein, albumin, lipid profiles, sodium, potassium, hemoglobin, white blood cell count, platelet count, mean platelet volume, thyroid stimulating hormone, free thyroid hormone values obtained simultaneously with 24-h ambulatory blood pressure results, as documented in the case records of 470 patients. Of the patients, 398 were in the nondipper hypertensive group and 72 in the dipper hypertensive group. Differences in serum biochemical, hematologic, and thyroid function parameters were compared between the groups. No statistically meaningful difference was detected between the age, gender, biochemical and hematologic parameters of the two groups. When the two were compared with respect to thyroid function tests, thyroid stimulating hormone levels in the nondipper hypertensive group were significantly higher, while free triiodothyronine and thyroxine levels were significantly lower. Thyroid function disorders are associated with hypertension. However, there are not enough data on the effects of thyroid hormones particularly on the nighttime blood pressure decrease in hypertensive patients. Although the exact mechanism between low thyroid hormone levels and nondipping hypertension development is not known, relatively low thyroid hormone levels in the nondipper group may be related to the decrease in vein wall compliance, considering the vascular effect of overt hypothyroidism.

Increased echocardiographic epicardial fat thickness is related to impaired diurnal blood pressure profiles

Objective. Epicardial fat has been proposed as a new cardiometabolic risk factor. Although epicardial fat thickness (EFT) is associated with hypertension, the relationship between diurnal blood pressure profiles and EFT is still unknown. The purpose of this study is to investigate the association between the echocardiographic EFT and diurnal blood pressure profiles in hypertensive patients. Methods. After the ambulatory blood pressures of 123 patients were monitored, they were divided into three groups according to the clinical diagnoses: 41 patients (33.3%) were in the normotensive group, 40 patients (32.5%) were in the dipper hypertensive group and 42 patients (34.1%) were in the non-dipper hypertensive group. All participants underwent transthoracic echocardiography and ambulatory blood pressure monitoring to measure the EFT and blood pressure responses. Results. The mean EFT measurements of the dipper group were significantly higher than the normotensive group (6.5 ± 0.6 vs 5.8 ± 0.6; p < 0.0001). On the other hand, the mean EFTs of the non-dipper group were also significantly higher than the dipper group (7.4 ± 0.7 vs 6.5 ± 0.6, p < 0.0001). An EFT of ≥ 7 mm predicted the non-dipper profile in hypertensive patients with 74% sensitivity and 71% specificity (receiving operator characteristic area under the curve: 0.826, 95% CI 0.738–0.913; p < 0.0001). EFT was associated with both dipper (OR 8.9, 95% CI 3.03–26.3; p < 0.0001) and non-dipper blood pressure profiles (OR 12.3, 95% CI 1.75–86.31; p < 0.0001), and this relationship was also independent from all the risk factors. Conclusion. Echocardiographic EFT assessment is independently associated with impaired diurnal blood pressure profiles in the hypertensive individuals. Thus, the echocardiographic assessment of the EFT may be helpful in cardiometabolic risk stratification and therapeutic interventions.

VARIES OF BLOOD PRESSURE AMONG ELDERLY PATIENTS WITH HYPERTENSION INDENTIFIED BY 24H AMBULATORY BLOOD PRESSURE MONITORING AT CAN THO GENERAL HOSPITAL

Objectives: 1. Comparing the average values artery blood pressure day and night in the elderly patients with hypertension dipper and non dipper. 2. Determining injury at a target organ between the two groups of patients with hypertension dipper and non dipper. Subjects and Methods: Patients aged 60 years or older have hypertension according to criteria of the Vietnam Heart Association to examination and treatment in Cardiology - Geriatric and Emergency Hospital in Can Tho city from December 2009 to August 2010, discontinuation of treatment of hypertension at least 24 hours. Exclude creamy hypertension, diabetes, stroke complications acute phase. Description interrupted. Testing of blood count, blood biochemistry and urine, ECG, echocardiogram, ophthalmoscopy. ABPM and Holter ECG measurement. Dipper: DI&gt; 10%, non-dipper: DI &lt;10%. Data processing by statistical methods conventional medicine. Results: The average nighttime blood pressure in dipper hypertension (95.17 ± 8.200 mmHg) lower than during the day (102.08 ± 8.867 mmHg), p &lt;0.001. Average blood pressure at night in the group non-dipper (98.74 ± 8.51 mmHg) higher than the value of the day (96.65 ± 9.406 mmHg), p &lt;0.01. Heart, eye, kidney and brain damage of the non-dipper hypertensive group have higher than dipper group (p &lt;0.01). Conclusion: The average nighttime blood pressure in dipper hypertension lower than during the day, p &lt;0.001, while the average blood pressure at night in the group non-dipper higher than the value of the day (p &lt;0.01). Heart, eye, kidney and brain damage of the non-dipper hypertensive group have higher than dipper group (p &lt;0.01). Key words: Elderly; ABPM; dipper, non-dipper hypertension; heart, fundus, kidney and brain complications.

CARDIOTROPHÝN 1 LEVELS IN NONDIPPER HYPERTENSIVE PATIENTS: PP.12.464

Background: Cardiotrophin 1 (CT-1) is an interleukin cytokine with known hypertrophic and proctective actions upon cardiac myocytes. We know that CT-1 increases in hypertension. In nondipper hypertension there is a high risk for cardiovascular mortality as compared dipper hypertension. There is no study about CT-1 levels in nondipper hypertension. In our study we investigated CT-1 levels in nondipper hypertension. Material Method: Patients having ischemic heart disease, valvular heart diseases, heart failure, and having any other systemic or metabolic diseases were excluded. Patients haven't took any hypertension drugs when hypertension was diagnosed. Dipper and nondipper hypertensive patients were determined by 24 hour ambulatory blood pressure meassurement (Tracker NIBP2, Reynolds Medical Ltd. Hertford England). Twenty six nondipper patients (15 women, mean age: 60,0 ± 13,6 years) and 21 dipper (11 women, mean age: 54,3 ± 12,4 years) were included to the study. CT-1 were determined by ELISA method (Human Cardiotrophin 1 USCN Inc. Wuhan China). SPSS 10.0 packed programme T-Test was used for stastical analyses. Results: There were no differences in dipper and non-dipper patients regarding to age, sex, height and weight. We didn't find any difference CT1 levels in nondipper hypertension group and dipper hypertension group (9,92 ± 2,08; 9,75 ± 1,64 pg/ml, respectively). Conclusion: In this study we found that CT1 levels was similar in nondipper hypertension group and dipper hypertension group. Although cardiovascular diseases in nondipper hypertensive patients are higher than dipper hypertensive patients, CT-1 levels found similar in both group.

Effects of dipper and non-dipper status of essential hypertension on left atrial mechanical functions

Aim: This study was designed in order to investigate the effects of dipper and non-dipper status of hypertension on left atrial mechanical (reservoir, conduit and booster pump) functions with left atrial volume measurements by means of two-dimensional echocardiography in untreated systemic hypertensive patients. Method: A total of 27 untreated dipper hypertensive patients, group I (15 female, 12 male, mean age 57±12 years); 23 untreated non-dipper hypertensive patients, group II (12 female, 11 male, mean age: 53±18 years); and 25 voluntary healthy individuals, group III (13 female, 12 male, mean age 53±10 years) were included into the study. Twenty-four hour blood pressure (BP) measurement was performed by the cuff-oscillometric method to evaluate the nocturnal decrease of BP. The patients whose night time mean blood pressure measurements were found 10% or more lower compared to mean day time measurements were classified as dipper hypertensive patients and the ones with a decrease of less than 10% were classified as non-dipper hypertensive patients. Left atrial (LA) volumes were measured echocardiographically according to biplane area-length method in apical four-chamber and two-chamber views. LA maximal volume ( V max) was recorded at the onset of mitral opening, LA minimal volume ( V min) was recorded at the onset of mitral closure and LA presystolic volume ( V p) was recorded at the beginning of the atrial systole (p wave on ECG). All volume measurements were corrected to body surface area, and following LA emptying functions parameters were calculated: LA passive emptying volume (LAPEV)= V max− V p, LA passive emptying fraction (LAPEF)=LAPEV/ V max, Conduit volume (CV)=left ventricular output volume-( V max− V min), LA active emptying volume (LAAEV)= V p− V min, LA active emptying fraction (LAAEF)=LAAEV/ V p, LA total emptying volume (LATEV)= V max− V min, LA total emptying fraction (LATEF)=LATEV/ V max. Results: LA volume indexes, V max, V min, and V p, were significantly increased in the hypertensive subgroups (groups I and II) than in controls ( p<0.001, p<0.001, p<0.001, respectively), but no significant difference was found in the V p values between group I and group II. V max and V min were larger in non-dipper hypertensive group than in dipper hypertensive group ( p<0.05 and p<0.05, respectively). LAPEV and LAPEF were observed to be significantly reduced in both dipper and non-dipper hypertensives than in control ( p<0.001 and p<0.05, respectively), and this difference was more obvious in non-dipper than dipper cases ( p<0.001). Conduit volume was significantly lower in hypertensive groups than controls ( p<0.05). LA active emptying volume ( p<0.001) and LAA active emptying fraction ( p<0.001) were significantly greater in hypertensive cases than in controls. Furthermore, LA active emptying volume in non-dipper hypertensive subjects was significantly greater than dipper hypertensive cases ( p<0.05). Left atrial total emptying volume and left atrial total emptying fraction in both hypertensive groups were similar to control ( p>0.05). Conclusions: Atrial reservoir and booster pump functions increase in hypertensive patients, but this result is more prominent in non-dipper hypertensives than in dipper hypertensive patients.