Noctural dipping status and left ventricular hypertrophy: A cardiac magnetic resonance imaging study

Jonathan C.L. Rodrigues, Antonio Matteo Amadu, Amardeep Ghosh Dastidar, Iwan Harries, Amy E. Burchell, Laura E.K. Ratcliffe, Emma C. Hart, Mark C.K. Hamilton, Julian F.R. Paton, Angus K. Nightingale, Nathan E. Manghat*

*Corresponding author for this work

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Abstract

We investigate the impact of dipper status on cardiac structure with cardiovascular magnetic resonance (CMR). Ambulatory blood pressure monitoring and 1.5T CMR were performed in 99 tertiary hypertension clinic patients. Subgroup analysis by extreme dipper (n=9), dipper (n=39), non-dipper (n=35) and reverse dipper (n=16) status was performed, matched in age, gender and BMI. Left ventricular (LV) mass was significantly higher for extreme dippers than dippers after correction for covariates (100±6g/m2 vs 79±3g/m2, P=0.004). Amongst extreme dipper and dippers (n=48), indexed LV mass correlated positively with the extent of nocturnal blood pressure dipping (R=0.403, P=0.005). On post-hoc ANCOVA, the percentage of nocturnal dip had significant effect on indexed LV mass (P=0.008), but overall SBP did not (P=0.348). In the tertiary setting, we found a larger nocturnal BP drop was associated with more LV hypertrophy. If confirmed in larger studies, this may have implications on nocturnal dosing of anti-hypertensive medications.
Original languageEnglish
Pages (from-to)784-793
Number of pages10
JournalJournal of Clinical Hypertension
Volume20
Issue number4
Early online date8 Mar 2018
DOIs
Publication statusPublished - Apr 2018

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Keywords

  • Hypertrophy
  • ambulatory blood pressure
  • nocturnal dip
  • myocardial strain

Cite this

Rodrigues, J. C. L., Amadu, A. M., Ghosh Dastidar, A., Harries, I., Burchell, A. E., Ratcliffe, L. E. K., Hart, E. C., Hamilton, M. C. K., Paton, J. F. R., Nightingale, A. K., & Manghat, N. E. (2018). Noctural dipping status and left ventricular hypertrophy: A cardiac magnetic resonance imaging study. Journal of Clinical Hypertension, 20(4), 784-793. https://doi.org/10.1111/jch.13235