Why the study?
What is the prevalence of non-dipping circadian blood pressure patterns and what factors are associated with it in Black patients with treated and untreated hypertension?
What is the prevalence of non-dipping circadian blood pressure patterns and what factors are associated with it in Black patients with treated and untreated hypertension?
Non-dipping blood pressure patterns are highly prevalent in both treated and untreated Black hypertensive patients and are strongly associated with cardiovascular risk factors such as diabetes and left ventricular hypertrophy.
Non-dipping BP patterns are highly prevalent in Black hypertensives and associated with diabetes and LVH; leaves open whether modifying these factors improves circadian control.
Objective: To determine the prevalence of circadian BP patterns and to assess factors associated with the non-dipping pattern in untreated and treated hypertensive patients, studied separately. Methods: Clinical data and ABPM were obtained from 52 untreated and 168 treated hypertensive patients referred for ABPM to Monkole Hospital in Kinshasa. Twenty-four ABPM was performed using an oscillometric device. Non-dipping pattern encompasses non-dipping (nocturnal systolic BP dip less than 10% of daytime systolic BP) and reverse dipping (mean night SBP higher than the day SBP). Results: the prevalence of non-dipping pattern was 75% (63.5% non-dipping and 11.5% reverse dipping) and 70% (60.1% non-dipping and 10.1% reverse dipping) in untreated and treated hypertensive patients, respectively. Advanced age (adjusted OR 1.80; 95%CI 1.96 - 3.38; p = 0.015), female sex (adjusted OR 2.28; 95%CI 1.19 - 4.36; p = 0.013), diabetes (adjusted OR 5.06; 95%CI 1.38 - 6.95; p = 0.014), reduced kidney function (adjusted OR 3.10; 95%CI 1.50 - 6.43; p = 0.018), inflammation (adjusted OR 2.65; 95%CI 1.76 - 6.48; p = 0.031), LVH (adjusted OR 4.45; 95%CI 1.78 - 7.67; p = 0.024) and antihypertensive therapy (adjusted OR 0.19; 95%CI 0.12 - 0.64; p = 0.018) emerged as the main independent factors significantly associated with the non-dipping pattern in the study population. Conclusion: the non-dipping pattern was a common finding in studied patients and associated with traditional and emerging risk factors suggesting that this abnormal pattern could be a marker of high cardiovascular risk.
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Mvunzi et al. (2017) studied this question.
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