The Association of Diastolic Dysfunction and Circadian Variation of Blood Pressure in Prehypertension

Objective: In this study, we aimed to investigate the relationship between circadian blood pressure variations and left ventricular diastolic functions in patients with prehypertension. Methods: The study population consisted of 48 patients with nondipper prehypertension and 60 patients with dipper prehypertension. Conventional diastolic function parameters, tissue Doppler, and color M-mode flow parameters were obtained during echocardiographic examination. Results: The early diastolic septal myocardial velocity (E' septal) and early diastolic lateral myocardial velocity (E' lateral) were significantly decreased in nondippers (7.0 +/- 1.2 cm/s vs 9.2 +/- 2.3 cm/s, P < .01 and 11.4 +/- 2.4 cm/s vs 10.2 +/- 2.4 cm/s, P < .05). Mitral propagation velocity (Vp) was also significantly lower in nondippers than in dippers (48.2 +/- 8.3 cm/s vs 61.3 +/- 25.2 cm/s, P < .05). The ratio of E/E' septal, E/E' lateral, and E/Vp was significantly different between dippers and nondippers. Conclusion: Diastolic parameters were impaired in nondipper prehypertensive patients. This may indicate diminished diastolic function that may contribute to hypertension in the near future. (J Am Soc Echocardiogr 2009;22:726-731.)