The Association Between Fragmented QRS on Electrocardiography and Blood Pressure Pattern in Patients With Hypertension

OBJECTIVE: Fragmented QRS (fQRS) complexes on electrocardiography (ECG) signify areal scar and fibrosis in the myocardium. Our aim was to investigate association between fragmented QRS and blood pressure pattern in hypertensive patients.MATERIAL AND METHODS: Patients underwent ambulatory blood pressure were studied retrospectively. Patients whose systolic blood pressure was 10-20% lower during the night when compared to the day were grouped as “dipping group”, while those who had a decrease less than 10% during the night were grouped as “non-dipping group”. The fQRS was defined as the presence of a second R wave, notching of R or S wave or fragmentation in two contiguous leads on ECG corresponding to epicardial major coronary artery region.RESULTS: The dipping group had 98 patients, while the non-dipping group had 89 patients. The groups were similar in terms of age, sex, body mass index, lipid profile and antihypertensive drugs. The fQRS was observed in 14 patients in the dipper group and 27 patients in the non-dipping group (p=0.008). The fQRS on ECG was found to be an independent predictor of non-dipping blood pressure pattern (p=0.046, odds ratio=2.27).CONCLUSIONS: The presence of fQRS was more than in hypertensives with non-dipping pattern compared with dipping pattern and this variable was a predictor of non-dipping pattern.