The comparison of cardiac and body morphometry in patients with non-dipper and reverse-dipper hypertension: a retrospective cross-sectional study

This study aimed to compare the relationship between non-dipper and reverse-dipper blood pressure (BP) patterns and cardiac and body morphometry in newly diagnosed hypertensive patients. This retrospective cross-sectional study included 315 newly diagnosed hypertensive patients (110 dippers, 105 non-dippers, and 100 reverse-dippers) with 24-hour ambulatory BP monitoring. The patients’ demographic, anthropometric, echocardiographic, and biochemical data were compared. Receiver operating characteristic (ROC) and multivariate logistic regression analyses were performed in order to identify factors that predict patterns other than the ‘dipper’ pattern. Age, unfavourable metabolic profiles (high glucose, low-density lipoprotein cholesterol, triglycerides, low high-density lipoprotein cholesterol), increased central obesity indicators [body mass index (BMI), waist circumference, body roundness index, waist-to-height ratio], cardiac structural changes (interventricular septal thickness (IVST), posterior wall thickness (PWT), ascending aorta diameter) and pulse pressure (PP) values were significantly higher in the non-dipper and reverse-dipper groups compared to the dipper group. The reverse-dipper group in particular exhibited the highest risk profile. Multivariate analyses confirmed that age, metabolic factors and anthropometric and cardiac morphometric measurements were all independent predictors of patterns other than the dipper pattern. ROC analysis revealed that BMI (cut-off value: 29.50 kg/m²), PWT (cut-off value: 11.05 mm) and IVST (cut-off value: 10.85 mm) demonstrated high diagnostic performance. This study demonstrated that non-dipper and reverse-dipper hypertension patterns are associated with a higher burden of cardiometabolic risk factors and more pronounced cardiac structural changes than the dipper type. As the reverse-dipper pattern has the most unfavourable risk profile, this group requires closer monitoring and more intensive treatment. Furthermore, the study determined that nighttime PP was significantly increased in reverse-dipper patients and that BMI and IVST values may be useful in predicting outcomes outside the dipper pattern. These easily accessible anthropometric and echocardiographic parameters hold significant clinical potential for the early identification of high-risk hypertensive individuals and the development of personalised treatment strategies.