The importance of frontal QRS-T angle for predicting non-dipper status in hypertensive patients without left ventricular hypertrophy

BACKGROUND: Frontal QRS-T angle is a novel marker of myocardial repolarization, and an increased frontal QRS-T angle associated with adverse cardiac outcomes. Non-dipper hypertension is also associated with adverse cardiac outcomes. This study aimed to investigate the relationship between frontal QRS-T angle and non-dipper status in hypertensive patients without left ventricular hypertrophy (LVH). METHODS: This study included 122 hypertensive patients without LVH. Patients were divided into two groups: dipper hypertension and non-dipper hypertension. The frontal QRS-T angle was calculated from 12-lead electrocardiography. RESULTS: Frontal QRS-T angle (47.9° ± 29.7° vs. 26.7° ± 19.6°, P < 0.001) was significantly higher in patients with non-dipper hypertension than in patients with dipper hypertension. In addition, frontal QRS-T angle was positively correlated with sleeping systolic (r = 0.211, P = 0.020), and diastolic (r = 0.199, P = 0.028) blood pressures (BP), even if they were weak. Multivariate analysis showed that the frontal QRS-T angle was independent predictor of non-dipper status (QR: 1.037, 95% CI: 1.019-1.056, P < 0.001). CONCLUSION: Frontal QRS-T angle is independent predictor of non-dipper status in hypertensive patients without LVH.