Objective: Development of left ventricular hypertrophy (LVH) is a multifactorial and incompletely understood process. Aim of our study was to determine the effect of blood pressure's (BP) circadian abnormalities on LVH. Design and method: We studied 780 consecutive newly diagnosed, never treated, non-diabetic, hypertensive patients stage I-III (51 ± 13 years old, 45.3% females). Echocardiographic left ventricular mass calculation was performed from parasternal long axis and normalized for height in meters to the power of 2.7 (LVMi). Using established cutoffs (>49 for males and >45 g/m2.7 for females), the study population was split in group with normal (n = 649) and increased LVMi (n = 131). Dipping status was defined according to day-night SAP circadian variation from 24 hour ambulatory blood pressure monitoring. Results: Patients with LVH were older (54 ± 13 vs 51 ± 13, p = 0.018), while there was no difference regarding gender (females 43.7 vs 45.6, p = 0.693). Prevalence of dippers was higher in patients with no LVH (50% vs. 35.6%), while there was no difference in the prevalence of non-dippers between the two groups (34.2 vs. 35.6). Moreover, prevalence of extreme dippers and reverse dippers was higher in patients with LVH (18.6% vs. 9.3% and 10.2% vs. 6.5%). Logistic regression analysis revealed that, compared to dippers, extreme dippers had 2.9 higher odds (95% CI: 1.5–5.5, p = 0.001) of LVH, independent of age, gender and body mass index, while reverse and non-dippers had no significant difference (OR: 1.8, 95% CI: 0.8–4, p = 0.132 and OR: 1.3, 95% CI: 0.8–2.3, p = 0.315, respectively). Conclusions: Extreme dipping status is an independent predictor of left ventricular hypertrophy.
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