Key result
Decreased deceleration capacity and increased acceleration capacity were identified as independent risk factors for blood pressure non-dipper status in essential hypertension.
Why the study?
This study aimed to investigate the potential association between the circadian rhythm of blood pressure and heart rate deceleration and acceleration capacities in patients with essential hypertension.
Observational (n=318)
No
Answers are grounded in this paper and cite their sources.
Abnormal heart rate deceleration and acceleration capacities are independently associated with a blunted decline in nighttime systolic blood pressure in patients with essential hypertension, suggesting a link to autonomic nervous dysfunction.
Background: This study aimed to investigate the potential association between the circadian rhythm of blood pressure and deceleration capacity (DC)/acceleration capacity (AC) in patients with essential hypertension. Methods: This study included 318 patients with essential hypertension who underwent 24-hour ambulatory blood pressure monitoring. Patients were categorized into three groups based on the percentage of nocturnal systolic blood pressure (SBP) dipping: the dipper, non-dipper and reverse dipper groups. Baseline demographic characteristics, ambulatory blood pressure monitoring (ABPM) parameters, Holter recordings (including DC and AC), and echocardiographic parameters were collected. Results: In this study, the lowest DC values were observed in the reverse dipper group, followed by the non-dipper and dipper groups (6.46±2.06 vs. 6.65±1.95 vs. 8.07±1.79 ms, P <.001). Additionally, the AC gradually decreased (-6.32±2.02 vs. -6.55±1.95 vs. -7.80±1.73 ms, P <.001). There was a significant association between DC (r=0.307, P<.001), AC (r=-0.303, P<.001) and nocturnal SBP decline. Furthermore, DC (β = 0.785, P =.001) was positively associated with nocturnal SBP decline, whereas AC was negatively associated with nocturnal SBP (β = -0.753, P<.002). By multivariate logistic regression analysis, deceleration capacity [OR (95% CI): 0.705 (0.594–0.836), p <.001], and acceleration capacity [OR (95% CI): 1.357 (1.141-1.614), p =.001] were identified as independent risk factors for BP nondipper status. The analysis of ROC curves revealed that the area under the curve for DC/AC in predicting the circadian rhythm of blood pressure was 0.711/0.697, with a sensitivity of 73.4%/65.1% and specificity of 66.7%/71.2%. Conclusions: Abnormal DC and AC density were correlated with a blunted decline in nighttime SBP, suggesting a potential association between the circadian rhythm of blood pressure in essential hypertension patients and autonomic nervous dysfunction.
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Wang et al. (2024) conducted an observational in Essential hypertension (n=318). Deceleration capacity and acceleration capacity vs. Normal circadian blood pressure rhythm (dippers) was evaluated on Blood pressure non-dipper status (OR 0.705, 95% CI 0.594-0.836, p=<0.001). Decreased deceleration capacity and increased acceleration capacity were identified as independent risk factors for blood pressure non-dipper status in essential hypertension.
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