Clinical and Demographic Characteristics of Dipper and Non-Dipper Hypertensive Patients at Moderate Altitude

Objective: Hypertension (HT) is a complex clinical syndrome influenced by lifestyle, genetics, mental stress, and environmental factors. High-altitude (H-ALT) is one environmental factor that affects the development of HT. This study aimed to analyze the clinical and demographic features of patients residing at moderate altitude (M-ALT).

Method: A total of 515 patients with hypertension, confirmed through 24-hour ambulatory blood pressure monitoring (ABPM), were screened. After exclusions, the final study population consisted of 452 patients. Participants were divided into two groups: dippers and non-dippers.

Results: Patients in the non-dipper group were older (standard deviation [SD]: 61 ± 13 vs. 54 ± 12 years, P < 0.001) and had a significantly higher waist circumference (SD: 104 ± 13 vs. 107 ± 12 cm, P = 0.022). However, patients in the dipper group had a significantly higher daytime mean systolic blood pressure (SBP) (SD: 144 ± 16 vs. 141 ± 17 mmHg, P = 0.027) and daytime mean diastolic blood pressure (DBP) (SD: 89 ± 12 vs. 87 ± 13 mmHg, P = 0.037). Patients in the non-dipper group also had a significantly higher proportion of abnormal left ventricular global longitudinal strain (LVGLS) (n = 218 (65.6%) vs. n = 53 (46.7%), P = 0.009).

Conclusion: In our study, patients with a non-dipper pattern of hypertension, which is associated with poor multisystemic outcomes, were found to have a higher waist circumference and subclinical left ventricular dysfunction (abnormal LVGLS). Furthermore, patients with a non-dipper pattern of hypertension comprised 76% of the study population.

Keywords: Altitude, demography, dipper hypertension, hypertension, non-dipper hypertension