Key result
Normotensive non-dipping links to greater target organ damage than dipping, including higher PWV and LVMI.
Why the study?
Circadian blood pressure abnormalities are established risk factors for cardiovascular and renal diseases, but their relationship with target organ damage in normotensive non-dipper subjects needed evaluation.
Does non-dipper circadian blood pressure status associate with increased target organ damage in normotensive subjects?
Cross-Sectional (n=464)
Does non-dipper circadian blood pressure status associate with increased target organ damage in normotensive subjects?
Absolute Event Rate: 7.57% vs 7.12%
p-value: p=0.02
Normotensive individuals with a non-dipper blood pressure pattern exhibit significantly greater signs of target organ damage, including increased arterial stiffness and left ventricular mass, compared to dippers.
Non-dipper pattern associates with greater target organ damage in normotensives; hypothesis-generating and requires prospective validation before clinical consideration.
Objective: Circadian blood pressure (CBP) abnormalities are well-known risk factors for many diseases such as cardiovascular, cerebrovascular, and chronic kidney disease. The object of this study was to evaluate the relationship between abnormalities in CBP rhythm and target organ damage (TOD) in normotensive non-dipper (non-DP) subjects.Methods: The 24-h ambulatory BP monitoring (ABPM) and echocardiography were performed and urinary albumin excretion (UAE) was measured in 127 normotensive dipper (DP) (42 males, 85 females) and 337 (89 males, 248 females) normotensive non-DP subjects.Results: When we compared DP and non-DP subjects; Pulse wave velocity (PWV) (7.12 ± 1.72 vs 7.57 ± 1.87 m/s, p = 0.02), the percentile of corrected PWV (cPWV) (7.1 vs. 20.2, p= 0.001) and the percentile of corrected augmentation index (cAIx) (23.5 vs. 33.9, p = 0.03), left ventricle mass index (LVMI) (78.00 ± 23.27 vs. 95.59 ± 18.29 g/m2, p = 0.01), relative wall thickness (RWT)(0.36 ± 0.13 vs 0.46 ± 0.09, p = 0.01), percentile of proteinuria (8.6 vs 29.2%, p = 0.00) were higher in non-DP group. In the correlation analyses, the PWV, LVMI, RWT were negatively correlated with the rate of systolic fall in nighttime (%)(−0.15, p = 0.01 vs. −0.23, p = 0.02 vs. −0.27, p = 0.00). It was observed that cPWV, cAIx, and UAE were independently associated with age and non-DP status (NDS), in logistic regression analysis.Conclusions: Our results suggested that normotensive persons with CBP abnormalities had TOD. In light of the data of this article, non-dipper status is detected in the early period and if the provision of diurnal blood pressure rhythm may reduce the incidence of future adverse events in nondipper normotensive subjects.
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Kılıç et al. (2019) conducted a cross-sectional in Normotension (n=464). Non-dipper circadian blood pressure rhythm vs. Dipper circadian blood pressure rhythm was evaluated on Pulse wave velocity (PWV) (p=0.02). Normotensive non-dipper subjects exhibited significantly higher target organ damage than dippers, including increased pulse wave velocity (7.57 vs 7.12 m/s, p=0.02) and left ventricular mass index.
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