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Background: Few studies have investigated the relationship between the lack of or reduction of nocturnal blood pressure (BP) fall and left ventricular mass (LVM) in elderly individuals with isolated systolic hypertension (ISH), notwithstanding the fact that ISH is the most frequent subtype of uncontrolled hypertension and a powerful risk factor for organ damage. The aim of this study was to identify the relationship between blunted nocturnal BP fall and LVM in elderly individuals with ISH that was recently diagnosed (within 2 years) and had never been treated., Methods: A total of 64 elderly patients with recent ISH were recruited among the outpatients of the Hypertension Unit at 1st Institute of Medicine of "La Sapienza" University in Rome, and they underwent 24-h ambulatory BP monitoring (ABPM). According to exclusion criteria, 37 patients were selected for the study. Based on the presence or absence of an almost 10% reduction in systolic BP (SBP) and diastolic BP (DBP) from day to night, 21 so-called dippers and 16 nondippers, respectively, were identified. All of these 37 patients underwent echocardiography. Relationships between BP recordings and echocardiographic parameters were assessed by univariate analysis. Dippers and nondippers were compared with respect to LVM., Results: Nighttime SBP was closely associated with indexed LVM (LVM/h(2.7)) (r = 0.564; P=.001). Nondippers showed significantly higher LVM/h(2.7) compared with dippers (62.43 +/- 15.39 g/m(2.7) v 51.33 +/- 12.68 g/m(2.7) respectively; P=.021)., Conclusions: An association between blunted nocturnal SBP fall and increased LVM was observed in the early phases of ISH in the elderly. This finding may have important prognostic implications.

Hypertensive subjects can be subdivided into 2 groups, dippers and nondippers, according to the presence or the lack of a nocturnal fall of blood pressure of more than 10%. Several studies have investigated cardiac organ damage in the 2 groups with discordant results, but they included subjects with different onset, severity, and treatment of hypertension. The authors selected 23 dippers and 17 nondippers affected by newly (< 1 year) diagnosed grades 1 and 2 hypertension, never treated, who underwent 24-hour ambulatory blood pressure monitoring and M-mode echocardiography. They did not find significant differences between the 2 groups as regards the echocardiographic left ventricular and atrial dimensions or regarding the left ventricular mass, left ventricular mass index, or relative wall thickness. Also no significant differences were found in the rate of either left ventricular remodeling or left ventricular hypertrophy. These data suggest that nondipping status is not associated with a higher level of cardiac involvement in the early phases of hypertension compared to dipping status.

Hypertensive subjects can be subdivided into 2 groups, dippers and nondippers, according to the presence or the lack of a nocturnal fall of blood pressure of more than 10%. Several studies have investigated cardiac organ damage in the 2 groups with discordant results, but they included subjects with different onset, severity, and treatment of hypertension. The authors selected 23 dippers and 17 nondippers affected by newly (< 1 year) diagnosed grades 1 and 2 hypertension, never treated, who underwent 24-hour ambulatory blood pressure monitoring and M-mode echocardiography. They did not find significant differences between the 2 groups as regards the echocardiographic left ventricular and atrial dimensions or regarding the left ventricular mass, left ventricular mass index, or relative wall thickness. Also no significant differences were found in the rate of either left ventricular remodeling or left ventricular hypertrophy. These data suggest that nondipping status is not associated with a higher level of cardiac involvement in the early phases of hypertension compared to dipping status. [ABSTRACT FROM AUTHOR]