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To evaluate the behavior of cardiac arrhythmias in dipper and nondipper hypertensive patients, 48-h ambulatory blood pressure monitoring, 24-h Holter electrocardiogram recording and echocardiographic studies were performed in 56 untreated outpatients with essential hypertension. These patients were divided into 2 groups according to the presence (dipper, n=33) or absence (nondipper, n=23) of reduction of both systolic and diastolic blood pressure during nighttime by an average of more than 10% of daytime blood pressure. Mean 48-h systolic and diastolic blood pressures did not differ between the 2 groups. Nondipper patients had a significantly larger left atrial dimension (31.9+/-3.8 vs 35.6+/-3.7 mm; p&lt;0.01), left ventricular mass index (114+/-26 vs 136+/-36 g/m2; p&lt;0.05), as well as a larger number of total supraventricular (16+/-19 vs 89+/-197 beats; p&lt;0.05) and ventricular ectopic beats (7+/-14 vs 47+/-96 beats; p&lt;0.05) during daytime as compared with dippers. In conclusion, nondipper hypertensive patients are likely to experience supraventricular and ventricular arrhythmias more frequently than dippers. A blunted nocturnal blood pressure fall may be involved in the appearance of cardiac arrhythmias in patients with essential hypertension.

Cardiac Arrhythmias and Left Ventricular Hypertrophy in Dipper and Nondipper Patients With Essential Hypertension