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Background Non-dipping blood pressure(BP)pattern is a potential risk factor contributing to cardiac geom-etry change.Relationship between BP pattern and left atrium(LA)enlargement besides left ventricle(LV)struc-tural change is seldom studied.Methods A total of 237 hypertensive and hospitalized adults were enrolled.Left heart chamber parameters were measured by 2-dimensional echocardiography,and BP circadian rhythm was eval-uated by 24-hour ambulatory blood pressure monitoring.Night-day ratios of systolic BP(NDR-SBP)were calcu-lated and BP patterns were classified into dippers,reduced-dippers,and risers,which were defined as NDR-SBP ＜0.9,≥0.9 and ＜1,≥1,respectively.Multiple logistic regression analyses were performed to identify the factors as-sociated with increased left ventricular end-diastolic internal diameter and left atrial diameter.Results Among enrolled participants,there were 62(26.2％)dippers,136(57.4％)reduced-dippers and 39(16.5％)risers.Briefly,57.8％were male and the mean age was 57.0±13.9 years.Compared to the dippers,both left ventricular end-dia-stolic diameter(44.4±4.3 mm in dippers,45.5±4.0 mm in reduced-dippers,46.5+4.5 mm in risers,P=0.045)and left atrial diameter(32.7±4.1 mm in dippers,34.3±4.7 mm in reduced-dippers,35.7+4.3 mm in risers,P=0.004)were progressively increased in reduced-dippers and risers.Logistic regression analyses showed that after adjust-ed for age,male gender,history of diabetes,blood lipid profiles,mean diurnal BP and estimated glomerular filtra-tion rate,the association between increased LV diameter and riser BP pattern was significant(OR:2.621,95％CI:1.030-6.678)while the association between increased LA diameter and riser BP pattern was marginally signif-icant.Conclusions The riser BP pattern is associated with the enlargement of LV and probably that of LA in hy-pertensive patients independent of 24-hour systolic BP level.