Association Between Metabolic and Atherogenic Indices and Circadian Blood Pressure Patterns in White-Coat Hypertension

Background and Objectives: The risk of cardiovascular events rises when hypertensive patients fail to achieve sufficient blood pressure reduction during nighttime hours. This study examined the association between metabolic and inflammatory biomarkers and non-dipper patterns in patients with white-coat hypertension. Materials and Methods: A total of two hundred and forty-four (244) patients with newly diagnosed white-coat hypertension were included in the study. The study used ambulatory blood pressure monitoring to classify patients as dippers (n = 86) and non-dippers (n = 158). The study evaluated metabolic markers through triglyceride–glucose (TyG) index, atherogenic index of plasma (AIP) and uric acid measurements against inflammatory markers including neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and monocyte/lymphocyte ratio. Results: The non-dipper group showed higher levels of uric acid (6.42 mg/dL vs. 5.65 mg/dL; p < 0.001), TyG index (8.82 vs. 8.51; p < 0.001), AIP (0.49 vs. 0.37 **; ** p < 0.001) and body mass index (26.0 kg/m2 vs. 24.1 kg/m2; p < 0.001) when compared to the dipper group. The inflammatory markers showed no significant variation between the groups. Uric acid showed the highest discriminative ability (AUC = 0.722). The research showed that each one mg/dL increase in uric acid levels was associated with 89% higher odds of non-dipper status (OR = 1.892; p = 0.002). A one-unit increase in the TyG index was associated with approximately 2.5-fold-higher odds. Conclusions: Levels of TyG index, uric acid, BMI and AIP were higher in patients with the non-dipper pattern compared to the dipper patients. The TyG index, uric acid levels, and BMI were independently associated with the non-dipper pattern in white-coat hypertension patients. These findings suggest that metabolic biomarkers may help identify individuals at higher risk for circadian blood pressure dysregulation.