Elmas Ali Nizami, Fedai Halil, Tanriverdi Zulkif
Clinic of Cardiology, Menderes State Hospital, Izmir, Turkey.
Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey.
Medicine (Baltimore). 2025 Sep 12;104(37):e44511. doi: 10.1097/MD.0000000000044511.
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.
非勺型高血压的定义为夜间血压（BP）较白天测量值下降<10%。这种情况与不良预后相关。电风险评分（ERS）是一种新型风险评分，可轻松从体表心电图计算得出。尽管许多心电图（ECG）参数已在非勺型高血压患者中分别进行了研究，但迄今为止尚无研究评估这些患者的ERS。我们的研究旨在评估非勺型高血压与ERS之间的关系。本回顾性研究共纳入302例诊断为高血压的患者。ERS参数包括：心率>75次/分钟、左心室肥厚、QRS过渡区≥V4、额面QRS-T角>90°、男性校正QT间期（QTc）>450毫秒，女性>460毫秒，以及Tp-e间期>89毫秒。使用异常心电图征象的数量来计算ERS。非勺型和勺型高血压组的基线特征具有可比性。然而，与勺型高血压患者相比，非勺型高血压患者的ERS显著更高（1[1-2]对2[1-3]，P<.001）。此外，ERS与夜间收缩压呈正相关（r=0.210，P<.001）。多因素逻辑回归分析表明，ERS是非勺型模式的独立预测因素（OR：1.935，95%CI：1.543至2.426，P<.001）。ERS是一种新型且易于获得的心电图风险评分系统。我们的研究表明，ERS可作为识别高血压患者非勺型模式的有益且有效工具。
