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Objective: The aim of this study was to investigate the impact of non-dipper arterial blood pressure pattern to right ventricular (RV) structure, diastolic and global function in metabolic syndrome (MS).Method: Study included 115 subjects with MS which was defined by the presence ≥3 ATP-NCEP-III criteria. Patients with pulmonary hypertension were excluded. All subjects underwent 24-hours ambulatory blood pressure monitoring and complete two-dimensional, pulsed and tissue Doppler echocardiography. We determined the ratio of early diastolic transtricuspid and septal area of the tricuspid annulus flow velocities (E/e'). Appropriate time intervals for estimation of Tei index were obtained by tissue Doppler. RV hypertrophy (RVH) was defined by RV wall thickness≥6.0/5.5mm in men and women, respectively.Results: Dipper blood pressure pattern was found in 63 (55%) MS subjects, while non-dipper pattern was present in 52 (45%) MS subjects. The E/e' ratio was higher in non-dippers (3.91+/-1.03 vs. 4.98+/-1.22, p<0.001), as well as the RV Tei index (0.35+/-0.07 vs. 0.44+/-0.09, p<0.001) and RV wall thickness (44.2+/-7.6 vs. 48.5+/-9.4 mm, p=0.008). Multiple logistic regression showed that non-dipper pattern (OR 3.02, 95%CI:1.15-7.32, p<0.001), and abdominal obesity (OR 1.72, 95%CI:1.01-6.97, p=0.041) were independent predictors of RV diastolic dysfunction (E/e'>6) in MS. Same analysis revealed that non-dipper pattern (OR 3.62, 95%CI:1.42-7.54, p<0.001) and abdominal obesity (OR 1.84, 95%CI:1.05-6.17, p=0.013) were independent predictors of RVH in MS subjects.Conclusions: RV structure, diastolic and global function was significantly impaired in non-dippers with MS. This kind of blood pressure pattern represents one of independent predictors of RV diastolic function and hypertrophy.