Cesare Cuspidi 1 , Carla Sala 2 , Marijana Tadic 3 , Marta Rescaldani 2 , Guido Grassi 4 , Giuseppe Mancia 5 Show Affiliations »
Abstract
AIM: The association of non-dipping (ND) pattern with cardiac damage is debated. We performed a meta-analysis in order to provide comprehensive information on subclinical cardiac alterations in untreated ND hypertensives. DESIGN: A computerized search was performed using PubMed, OVID, EMBASE, and Cochrane library databases from 1 January 1990 up to 31 October 2014. Full articles published in English language providing data on subclinical cardiac damage in ND as compared to dipper (D) hypertensives, as assessed by echocardiography, were considered. RESULTS: A total of 3,591 untreated adult subjects (1,291 ND and 2,300 D hypertensives) included in 23 studies were considered. Left ventricular (LV) mass index (LVMI) was higher in ND than in D hypertensives (122±3.8 g/m2 vs. 111±3.3 g/m2, standardized mean difference, SMD: 0.40±0.07, confidence interval (CI): 0.26-0.53, P < 0.001); relative wall thickness (RWT) and left atrium (LA) diameter were greater (SMD: 0.14±0.005, CI: 0.05-0.23, P = 0.002; 0.36±0.10, CI: 0.16-0.56, P < 0.001, respectively), while mitral E/A ratio was lower in ND than in D counterparts (SMD: -0.23±0.08, CI: -0.39 to -0.08, P = 0.003). After assessing data for publication bias, the difference between groups was still significant, with the exception of E/A ratio. CONCLUSIONS: Our meta-analysis supports an association between ND pattern and increased risk of LV structural alterations in untreated essential hypertensives. This observation supports the view that an effective BP control throughout the entire 24-hour cycle may have a key role in preventing or regressing subclinical cardiac damage associated to ND pattern. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
AIM: The association of non-dipping (ND) pattern with cardiac damage is debated. We performed a meta-analysis in order to provide comprehensive information on subclinical cardiac alterations in untreated ND hypertensives . DESIGN: A computerized search was performed using PubMed, OVID, EMBASE, and Cochrane library databases from 1 January 1990 up to 31 October 2014. Full articles published in English language providing data on subclinical cardiac damage in ND as compared to dipper (D) hypertensives , as assessed by echocardiography, were considered. RESULTS: A total of 3,591 untreated adult subjects (1,291 ND and 2,300 D hypertensives ) included in 23 studies were considered. Left ventricular (LV) mass index (LVMI) was higher in ND than in D hypertensives (122±3.8 g/m2 vs. 111±3.3 g/m2, standardized mean difference, SMD: 0.40±0.07, confidence interval (CI): 0.26-0.53, P < 0.001); relative wall thickness (RWT) and left atrium (LA) diameter were greater (SMD: 0.14±0.005, CI: 0.05-0.23, P = 0.002; 0.36±0.10, CI: 0.16-0.56, P < 0.001, respectively), while mitral E/A ratio was lower in ND than in D counterparts (SMD: -0.23±0.08, CI: -0.39 to -0.08, P = 0.003). After assessing data for publication bias, the difference between groups was still significant, with the exception of E/A ratio. CONCLUSIONS: Our meta-analysis supports an association between ND pattern and increased risk of LV structural alterations in untreated essential hypertensives . This observation supports the view that an effective BP control throughout the entire 24-hour cycle may have a key role in preventing or regressing subclinical cardiac damage associated to ND pattern. © American Journal of Hypertension , Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Entities: Chemical
Disease
Keywords:
blood pressure; essential hypertension; hypertension; non-dipping; subclinical cardiac damage.
Mesh： See more »
Year: 2015
PMID： 26108212 DOI： 10.1093/ajh/hpv094
Source DB: PubMed Journal: Am J Hypertens ISSN： 0895-7061 Impact factor: 2.689