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Disturbed circadian blood pressure rhythm and C-reactive protein in essential hypertension

C Tsioufis1, D Syrseloudis, K Dimitriadis

  • 1First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece. ktsioufis@hippocratio.gr

Journal of Human Hypertension
|April 4, 2008
PubMed

Insights

Essential hypertensive non-dippers show elevated inflammatory markers (hs-CRP) compared to dippers, regardless of how dipping status is defined. Ambulatory pulse pressure and nocturnal blood pressure fall are linked to these inflammatory processes.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Inflammation Biology

Background:

  • Blood pressure dipping status is a key indicator in hypertension management.
  • Non-dipping patterns are associated with increased cardiovascular risk and inflammation.
  • Diverse definitions of dipping status may influence research outcomes.

Purpose of the Study:

  • To investigate how different criteria for defining dipping and non-dipping status affect inflammatory differences in essential hypertension.
  • To analyze the relationship between blood pressure variability, inflammatory markers, and dipping status.

Main Methods:

  • Ambulatory blood pressure monitoring and high-sensitivity C-reactive protein (hs-CRP) measurement in 269 untreated essential hypertensive patients.
  • Classification of participants into dippers and non-dippers using three distinct definitions: true non-dippers, true dippers/non-dippers, and systolic non-dippers.
  • Statistical analysis including multiple regression to identify predictors of hs-CRP levels.

Main Results:

  • Non-dippers consistently showed higher hs-CRP levels and 24-hour pulse pressure compared to dippers across all three classification methods.
  • Elevated log hs-CRP was observed in non-dippers by 0.11-0.14 mg l(-1) (P=0.02-0.03).
  • Twenty-four hour pulse pressure and nocturnal systolic blood pressure fall were independent predictors of log hs-CRP.

Conclusions:

  • Essential hypertensive non-dippers exhibit increased inflammatory activation (higher hs-CRP) compared to dippers, irrespective of the specific definition used for dipping status.
  • Ambulatory pulse pressure and nocturnal systolic blood pressure fall are interconnected and play a role in the inflammatory processes associated with the non-dipping state.
  • These findings highlight the clinical relevance of consistent blood pressure monitoring and inflammatory marker assessment in non-dipper hypertensive patients.

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