Relationship between morning blood pressure surge and the frontal plane QRS-T angle in newly diagnosed hypertensive patients

Background Morning blood pressure surge (MBPS) plays an important role in target organ damage and major adverse cardiac events. The frontal QRS-T [f(QRS-T)] angle is the electrocardiographic marker and index of ventricular arrhythmogenic events. We aimed to investigate the relationship between MBPS and the f(QRS-T) angle, which is an indicator of ventricular repolarization disorder, in patients with newly diagnosed HT. Methods Between June 2020 and March 2021, 263 patients with newly diagnosed HT who were admitted to our outpatient clinic were prospectively included in the study. According to ambulatory blood pressure monitoring (ABPM), the patients were categorized into two groups: Group-I: low-value MBPS (<37 mm Hg), and group-II: high-value MBPS (>= 37 mm Hg). The f(QRS-T) angle calculated from the 12-lead electrocardiogram and all other data were compared between the groups. Results A total of 186 newly diagnosed HT patients who met the inclusion criteria were included in the study. The average f(QRS-T) angle in Groups I and 2 was 21 degrees +/- 16 degrees and 51 degrees +/- 30 degrees, respectively (P < .001). According to multivariate regression analysis, T peak-end and MBPS were found to be independent predictors of the f(QRS-T) angle. Conclusions As a result of our study, we found that the f(QRS-T) angle was widened in patients with exaggerated MBPS. The cause of increased cardiovascular outcomes in patients with exaggerated MBPS may be explained by widened in the f(QRS-T) angle that is a ventricular repolarization parameter.

Automated summary

The study revealed that the f(QRS-T) angle was significantly widened in patients with exaggerated MBPS, indicating a severe ventricular repolarization disorder in these patients. Both MBPS and T peak-end were identified as independent predictors of the f(QRS-T) angle.