Key result
Abnormal circadian blood pressure profiles affect ~55% of treated hypertensives, with older age blunting nocturnal dipping.
Why the study?
Abnormal nocturnal fall in blood pressure increases cardiovascular risk, so this study aimed to analyze the circadian blood pressure profile in treated hypertensive patients and identify factors affecting the variability of nocturnal blood pressure fall.
What is the prevalence of abnormal circadian blood pressure profiles during 24-hour ABPM in treated hypertensive patients, and what clinical factors affect the variability of nocturnal blood pressure fall?
Cross-Sectional (n=161)
No
What is the prevalence of abnormal circadian blood pressure profiles during 24-hour ABPM in treated hypertensive patients, and what clinical factors affect the variability of nocturnal blood pressure fall?
Over half of treated hypertensive patients exhibit an abnormal circadian blood pressure profile on 24-hour ABPM, with nocturnal blood pressure dipping declining significantly with advancing age regardless of comorbidities.
Background Evaluation of circadian blood pressure (BP) profile is an important element of ambulatory BP monitoring (ABPM). Abnormal nocturnal fall in BP is more common in patients with secondary causes of hypertension and in the elderly. Cardiovascular risk is substantially increased in these patients. Aim Analysis of circadian BP profile in a population of treated hypertensives and identification of factors affecting variability of nocturnal fall in BP. Methods 24-h ABPM was performed in hypertensive patients. Based on nocturnal fall pattern, four subgroups were identified:dippers, non-dippers, extreme dippers, and risers. Comorbidities were assessed, and data obtained in all groups were compared with the dipper profile group. Results We analysed 161 patients (86 men, 53.4%). A dipper profile was noted in 44.7% of patients. Abnormal circadian BP profile was observed in 55.3% of patients, including a non-dipper profile in 21.1% of patients, an extreme dipper profilein 32.3% of patients, and a riser profile in 1.9% of patients. No significant differences in the rates of dyslipidaemia, previous myocardial infarction, previous stroke, and coronary artery disease were seen between the groups. The whole study population was also characterised by similar rates of excessive body weight and abdominal obesity. Conclusions An abnormal circadian BP profile was found in over 50% of hypertensive patients. A negative correlation was found between nocturnal BP fall and the patient age. No differences were found between groups with different circadian BP pattern regarding duration of hypertension and the presence of dyslipidaemia, obesity, diabetes, or coronary artery disease.
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Salwa et al. (2014) conducted a cross-sectional in Treated hypertension (n=161). Abnormal circadian blood pressure profile (non-dippers, extreme dippers, risers) on 24-hour ABPM vs. Dipper blood pressure profile (nocturnal MAP fall of 10-20%) was evaluated on Prevalence of abnormal circadian blood pressure profile and correlation between nocturnal blood pressure fall and patient age (r = -0.2368, p=0.002). Abnormal circadian blood pressure profiles occurred in 55.3% of treated hypertensive patients, with nocturnal blood pressure fall correlating negatively with age (r = -0.2368, p = 0.002).
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