Key result
An extreme dipping blood pressure pattern was not associated with an increased risk of cardiac hypertension-mediated organ damage after adjusting for confounders.
Why the study?
Information regarding the association of hypertension-mediated organ damage with the extreme dipping pattern was scanty and not univocal.
Does an extreme dipping blood pressure pattern increase the risk of subclinical cardiac organ damage in the general population?
Cross-Sectional (n=1,597)
Does an extreme dipping blood pressure pattern increase the risk of subclinical cardiac organ damage in the general population?
An extreme dipping blood pressure pattern is highly prevalent in the general population but is not independently associated with an increased risk of subclinical cardiac organ damage.
No independent link to cardiac damage after adjustment; leaves open longitudinal prognostic value of extreme dipping.
AIM: Information regarding the association of hypertension-mediated organ damage (HMOD) with extreme dipping pattern is scanty and not univocal. We sought to assess the clinical correlates of this blood pressure (BP) phenotype and its relationship with cardiac HMOD in the general population belonging to Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study. METHODS: The present analysis included all participants with good-quality ABPM recordings with reliable echocardiography at entry. RESULTS: A total of 792 out of 1597 patients (49.6%) exhibited an extreme dipping pattern (155 had a night-time reduction in both SBP and DBP at least 20% compared with daytime values and 637 a night-time reduction in DBP at least 20%); 34.2% were dippers and 16.2% nondippers. Left ventricular mass (LVM) indexed to height and LV hypertrophy (LVH) prevalence rates increased progressively from diastolic extreme dipping (14%), dipper (17%), systolic/diastolic extreme dipping (21%) to nondipper group (27%). However, after adjusting for confounders, statistical differences in both LVMI and LVH rates among the four groups disappeared. Similar results were obtained for LVM indexed to body surface area and absolute/indexed left atrial diameter. CONCLUSION: Extreme dipping pattern is a BP phenotype highly frequent in the general population largely consisting of middle-aged individuals without prevalent cardiovascular disease. In this population, the extreme dipping pattern is not associated with an increased risk of cardiac HMOD, which suggests that the mechanisms invoked for the potential adverse cardiovascular effects of this condition (i.e. nocturnal hypoxemia, low-grade myocardial inflammation, coronary hypoperfusion, sympathetic activation at early morning, etc.) are not operative.
No takes yet. Share an insight, caveat, or question.
Cuspidi et al. (2020) conducted a cross-sectional in Extreme dipping blood pressure pattern (n=1,597). Extreme dipping pattern vs. Dipper and nondipper patterns was evaluated on Left ventricular hypertrophy (LVH) prevalence. An extreme dipping blood pressure pattern was not associated with an increased risk of cardiac hypertension-mediated organ damage after adjusting for confounders.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: