Evaluation of the relationship between ?Dipper? And ?Nondipper? hypertension types in hypertensive patients without known coronary heart disease in terms of aortic strain, distensibility and stifness, carotis intima media thickness and diastolic dysfunction

Introduction: The relationship between cardiovascular diseases and the diurnal rhythm of hypertension was researched in many studies. In these studies "non-dipper" hypertensive patients without nocturnal blood pressure decline had also inadequate nocturnal reduction in cardiac index, pulse index and sympathic activity. Thus, cardiovascular system is exposed to higher blood pressure in the night time and compensatory structural and functional changes of the body to overcome causeirreversible detriment in the whole vascular system.Objective: In hypertensive patients without known coronary heart disease ,evaluation of the relationship between parameters such as aortic stiffness, elasticity and rigidity, carotid intima media thickness and diastolic dysfunction in terms of "dipper" and "non-dipper" hypertension subtypes was intended.Material and Method: A total of 54 patients ,whose ages were ranging between 30 and 70 years and which consisted of 35 male (68.6%) and 19 female (31.4%) hypertensive patients without known coronary heart disease were recruited to our study. All patients were classified as "dipper" or "non-dipper" after ambulatory blood pressure follow-up. Patients' left ventricular systolic and diastolic functions were assessed with transthoracic echocardiography. Their ascending aorta diameters and carotid intima media thickness were measured ultrasonographically and the elasticity parameters of aorta were calculated by using relevant formula.Results: No statistically significant difference was detected between demographic and echocardiographic data of recruited patients. In the non-dipper hypertension group aortic rigidity was found increased and ,aortic tension and elasticity were found decreased significantly compared to those of dipper hypertension group. Carotid intima media thickness was also found significantly elevated in the non-dipper group compared to that of dipper group. In addition, a significant correlation was noted between carotid intima media thickness and mean blood pressure. No significant difference was detected between two groups in terms of left ventricular hypertrophy and diastolic dysfunction.Conclusion: In our study we showed that impairment of aortic elasticity parameters and increase in carotid intima media thickness as a predictor of end organ damage were more often in the non-dipper hypertensive patients.