Key result
Functional capacity indices, including maximum heart rate (β = 0.26, p = 0.01) and metabolic equivalents (β = 0.21, p = 0.04), emerged as significant but small predictors of the degree of nighttime systolic blood pressure dipping.
Cross-Sectional (n=96)
No
Effect estimate: β = 0.26
p-value: p=0.01
Variables reflecting basic heart function and fitness (maximum heart rate and METs) account for only a small variance in nighttime blood pressure dipping, suggesting nocturnal hypertension is a complex, multi-faceted phenomenon.
Small fitness-dipping associations warrant no practice change; leaves open multifactorial nocturnal hypertension mechanisms in observational data.
BACKGROUND: Absences of normative, 10-20 % declines in blood pressure (BP) at night, termed nocturnal non-dipping, are linked to increased cardiovascular mortality risks. Current literature has linked these absences to psychological states, hormonal imbalance, and disorders involving hyper-arousal. This study focuses on evaluating associations between nocturnal non-dipping and indices of functional cardiac capacity and fitness. METHODS: The current study was a cross-sectional evaluation of the associations between physical capacity variables e.g. Metabolic Equivalent (MET) and Maximum Heart Rate (MHR), Heart rate reserve (HRR), and degree of reduction in nocturnal systolic blood pressure (SBP) or diastolic blood pressure (DBP), also known as 'dipping'. The study sample included 96 cardiac patient participants assessed for physical capacity and ambulatory blood pressure monitoring. In addition to evaluating differences between groups on nocturnal BP 'dipping', physical capacity, diagnoses, and medications, linear regression analyses were used to evaluate potential associations between nocturnal SBP and DBP 'dipping', and physical capacity indices. RESULTS: 45 males and 14 females or 61.5 % of 96 consented participants met criteria as non-dippers (<10 % drop in nocturnal BP). Although non-dippers were older (p = .01) and had a lower maximum heart rate during the Bruce stress test (p = .05), dipping was only significantly associated with Type 2 Diabetes co-morbidity and was not associated with type of medication. Within separate linear regression models controlling for participant sex, MHR (β = 0.26, p = .01, R(2) = .06), HRR (β = 0. 19, p = .05, R(2) = .05), and METs (β = 0.21, p = .04, R(2) = .04) emerged as significant but small predictors of degree of nighttime SBP dipping. Similar relationships were not observed for DBP. CONCLUSIONS: Since the variables reflecting basic heart function and fitness (MHR and METs), did not account for appreciable variances in nighttime BP, nocturnal hypertension appears to be a complex, multi-faceted phenomena.
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Ritvo et al. (2015) conducted a cross-sectional in Nocturnal hypertension (n=96). Functional capacity (Maximum Heart Rate and METs) was evaluated on Degree of nighttime systolic blood pressure dipping (β = 0.26, p=0.01). Functional capacity indices, including maximum heart rate (β = 0.26, p = 0.01) and metabolic equivalents (β = 0.21, p = 0.04), emerged as significant but small predictors of the degree of nighttime systolic blood pressure dipping.
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