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Hypertension is a major risk factor for cardiovascular disease. The non-dipper form of hypertension is associated with progressive end organ damage. Diastolic dysfunction may increase the left ventricular end diastolic pressure leading to pulmonary hypertension and right ventricular strain. The purpose of this study was to evaluate right ventricular function in patients with non-dipper hypertension.
One-hundred-and-thirty-one hypertensive consecutive patients without diabetes and thirty-nine healthy subjects (the control group) were evaluated at the outpatient clinic and enrolled in the study. Right ventricular tissue Doppler, myocardial performance ındex(MPI) and tricuspid anular plane systolic excursion (TAPSE) were evaluated with echocardiography. 24-hour ambulatory blood pressure monitoring enabled the study population to be divided into 2 groups=42 patients with dipper hypertension and 46 with non-dipper hypertension.
There was no significant difference regarding demographic characteristics and body mass index between the groups. Non-dipper pattern patients had a lower TAPSE compared to dippers but the difference did not reach statistical significance (2.19±0.29 and 2.29±0.31 p=0.17). Non dipper hypertensive patients had significantly lower TAPSE compared to the control group (2.19±0.29 and 2.37±0.28 p=0.006). Dipper hypertensive patients did not have a significant difference compared with the control group (2.29±0.31 and 2.37±0.28 p=0.39). The comparison of three groups suggests a progressive decrease in TAPSE values from normals to dipper and non dipper hypertensive patients. Tissue Doppler right ventricular E/A ratio is significantly different in dipper (0.77±0.30 vs 0.91±0.39, p<0.001) and non-dipper (0.77±0.30 vs 0.91±0.39, p<0.001) hypertensive patients compared to control group.
Hypertension can also affect the right ventricular function as it affects the left ventricular diastolic function. Our results suggest that the effect on right ventricular function is more evident in patients with non-dipper hypertension compared to patients with dipper pattern of blood pressure.