Key result
Non-hypertensive Alzheimer disease patients exhibited significantly different circadian blood pressure rhythms compared to normotensive controls, driven by higher night systolic blood pressure (p<0.001).
Why the study?
Does the circadian rhythm of arterial blood pressure differ between non-hypertensive Alzheimer disease patients and normotensive controls?
Case-Control
Does the circadian rhythm of arterial blood pressure differ between non-hypertensive Alzheimer disease patients and normotensive controls?
Effect estimate: χ2 = 56.76
p-value: p=< 0.001
Non-hypertensive Alzheimer disease patients exhibit an altered circadian blood pressure rhythm, characterized by a higher prevalence of non-dipping and reverse-dipping patterns, compared to normotensive controls.
Altered nocturnal BP in non-hypertensive AD may prompt closer monitoring; leaves open causal role and need for prospective trials before practice change.
OBJECTIVES: The circadian rhythm (CR) of arterial blood pressure (ABP) in Alzheimer disease (AD) patients was examined in a case-control clinical study. METHODS: This study was constructed using the case-control method and investigates non-hypertensive AD patients, compared with normotensive controls from a primary care setting. Twenty-four-hour ABP was measured with an automatic oscillometric device and recorded every 30 min throughout the day and night. Extreme dipper, dipper, non-dipper and reverse-dipper patterns were defined as those individuals with > 20%, 10-20%, < 10% and no fall in nocturnal ABP relative to daytime values. RESULTS: There were significant differences in ABP dipper status between cases and controls (cases - 16.15%, 60.00%, 17.70% and 6.15% vs controls - 3.19%, 31.9 2%, 42.02% and 22.88% for reverse dipper, non-dipper, dipper and extreme dipper, respectively, df = 3, χ(2) = 56.76, p < 0.001). Compared with normal controls, AD patients had significantly higher 24-h mean blood pressure, 24-h mean systolic blood pressure (SBP), night mean SBP, night mean pulse pressure (PP) and 24-h mean PP. There were no significant differences in 24-h mean diastolic blood pressure (DBP), daytime mean DBP or night-time mean DBP, and no significant differences in daytime mean SBP. CONCLUSIONS: The circadian rhythm of ABP in AD patents differed from normal controls, perhaps from higher night SBP in AD patents.
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Chen et al. (2012) conducted a case-control in Alzheimer disease without hypertension. Alzheimer disease vs. Normotensive controls was evaluated on Arterial blood pressure dipper status (χ2 = 56.76, p=< 0.001). Non-hypertensive Alzheimer disease patients exhibited significantly different circadian blood pressure rhythms compared to normotensive controls, driven by higher night systolic blood pressure (p<0.001).
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