To be non-dipper: a higher cardiovascular risk?

To assess whether the frequency of cardiovascular risk factors and end-organ damage is greater among non-dipper hypertensive patients. Descriptive cross-sectional study involving 290 hypertensive patients at an urban primary care center. All patients underwent 24-hour ambulatory blood pressure measurement (ABPM). The following variables were included: age, sex, diabetes, hypercholesterolemia, smoking, obesity, Joint National Committee VI (JNC-VI) high blood pressure (HBP) stage, dipper or non-dipper status, end-organ damage: renal (microalbuminuria, creatinine elevation), cardiac (left ventricular hypertrophy, ischemic heart disease), and cerebrovascular (acute cerebrovascular accident or transient ischemic attack). 162 patients (56.8%) were women. 61.2% of the whole sample were non-dippers, women being here the predominant group (61.5%) with a significant difference (p=0.047). Mean age of non-dippers was 60.4 years (SD 11.8) whereas that of dippers was 55.5 (SD 11.5) (p>0.004). In the older-than-65 group, there were more non-dippers than in the younger group (54.9% vs 45.1%; p<0.05, CI 95% [5.3;30.8]). There were more non-dippers than dippers in the 3rd stage of the JNC-VI (12.6% vs 3.6%; p<0.05; CI [2.96;15]). No differences were found in cardiovascular risk factors and end-organ damage between dippers and non-dippers except for cerebrovascular disease (6.3% vs 0.9%; p=0.046, CI [1.38;9.39]). Frequency of non-dippers is higher in the elder (older than 65 years). Cerebrovascular disease and higher HBP stages occur more frequently among non-dippers. We did not find any differences between dippers and non-dippers as regards the rest of the cardiovascular risk factors and end-organ damage. Am J Hypertens (2004) 17, 205A–205A; doi: 10.1016/j.amjhyper.2004.03.545