Author + information
Hypertension is principal problem increasing nowadays and threatens community health by its complications. In healthy adults, blood pressure levels decrease nocturnally. ‘Dipper’ are the ones whose systolic blood pressure decrease >10% at night and ‘nondipper’ are the whose ones systolic blood pressure decrease <10% at night. In the nondippers group cardiovascular morbidity and mortality are increased. Myocardial performance index (MPI) is a relatively new index which can be used in evaluation systolic and diastolic performance and may have prognostic value for a variety of heart diseases.
Our aim in this study is to search for the effect of diurnal blood pressure on myocardial performance index and aortic elasticity parameters in essential hypertensive patients.
Our study comprised 30 dippers, 31 nondippers hypertensive patients and 25 healthy volunteers. Ambulatory blood pressure monitoring (ABPM) was hooked-up to hypertensive patients and they were grouped as dippers and nondippers. All individuals were measured aortic elasticity parameters and MPI by used to transthoracic echocardiography (Figure 1).
The groups are similar in term of age, sex, body mass index, using cigarette and biochemical parameters. There was no significant difference between the groups in terms of MPI (p=0.110). Aortic strain index was lower in control group than dipper hypertensive and nondipper hypertensive group (p<0.0001, p<0.0001 respectively), and distensibility index was lower in control group than dipper and nondipper hypertensive group (p<0.0001, p<0.0001 respectively). The index of aortic stiffness; there was no significant difference between the control and dipper hypertensive groups (p=0.087). However, the aortic stiffness index in nondipper hypertensive group was higher than dipper hypertensive group (p<0.0001).
In our study we found a relationship among nondipper hypertension decreased aortic strain and aortic distensibility and increased aortic stiffness. Also, dipper hypertension related to decreased aortic strain and aortic distensibility. Nondipper hypertension known has more increased cardiovascular event and mortality risk. In this context, patients with hypertension should be followed with ABPM. Therefore nondipper hypertensive patients which have a higher risk can be identified. Thus, efforts for controlling blood pressure in nondipper hypertensive patients provide better risk modification.