The relationship between circadian blood pressure patterns and electrical risk score in patients with hypertension

Non-dipper hypertension is defined as a decline in nighttime blood pressure (BP) of <10% compared to daytime measurements. This condition is associated with poor prognosis. The electrical risk score (ERS) is a novel risk scoring and can easily be calculated from the surface electrocardiography. Although many Electrocardiography (ECG) parameters have been investigated separately in patients with non-dipper hypertension, no study has evaluated ERS in these patients to date. Our study aimed to assess the relationship between non-dipper hypertension and ERS. A total of 302 patients diagnosed with hypertension were enrolled in this retrospective study. The ERS parameters included: heart rate > 75 bpm, presence of left ventricular hypertrophy, QRS transition zone ≥ V4, frontal QRS-T angle > 90°, corrected QT Interval (QTc) interval > 450 ms in males and > 460 ms in females, and Tp-e interval > 89 ms. The number of abnormal ECG signs was used to calculate the ERS. Baseline characteristics were comparable between the non-dipper and dipper hypertension groups. However, patients with non-dipper hypertension had significantly higher ERS compared to patients with dipper hypertension (1 [1-2] vs 2 [1-3], P < .001). In addition, ERS was positively correlated with nighttime systolic blood pressure (r = 0.210, P < .001). Multivariate logistic regression analysis demonstrated that ERS was the independent predictor of non-dipper pattern (OR: 1.935, 95% CI: 1.543 to 2.426, P < .001). ERS is a novel and easily obtainable electrocardiographic risk scoring system. Our study shows that ERS may be used as a beneficial and effective tool for identifying the non-dipper pattern in patients with hypertension.