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The relationship between dipper/nondipper pattern and cardioankle vascular index in hypertensive diabetic patients

Ezgi Kalaycioğlu1, Tayyar Gökdeniz, Ahmet Ç Aykan

  • 1Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey. ezgikalay@gmail.com

Blood Pressure Monitoring
|June 15, 2013
PubMed

Insights

Hypertensive diabetic patients with a nondipper blood pressure pattern show increased arterial stiffness. This finding highlights the need for close cardiovascular event monitoring in this high-risk group.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Endocrinology

Background:

  • 24-hour ambulatory blood pressure monitoring (24-h ABPM) is superior to spot measurements for predicting cardiovascular events (CVEs) in hypertensive diabetic patients.
  • The mechanism linking a nondipper BP pattern to increased CVEs in this population remains unclear.
  • Cardio-ankle vascular index (CAVI) quantifies overall arterial stiffness from the aorta to the ankle.

Purpose of the Study:

  • To investigate the relationship between dipper/nondipper patterns identified by 24-h ABPM and arterial stiffness measured by CAVI.
  • To assess arterial stiffness in hypertensive patients with type-2 diabetes mellitus.

Main Methods:

  • Ninety-nine hypertensive patients with type-2 diabetes mellitus were enrolled.
  • 24-h ABPM and CAVI measurements were conducted for all participants.
  • Statistical analyses examined the association between BP patterns and CAVI.

Main Results:

  • A nondipper BP pattern was observed in 63.6% of patients.
  • Univariate analysis revealed higher CAVI, asleep mean arterial pressure (MAP), overall BP, hypertension duration, and statin use in nondippers.
  • Multivariate analysis indicated that the difference between asleep and awake MAP independently predicted CAVI, and CAVI negatively correlated with nocturnal MAP decline.

Conclusions:

  • The nondipper BP pattern in hypertensive diabetic patients is associated with increased arterial stiffness.
  • This increased arterial stiffness suggests a higher risk for cardiovascular events.
  • Close monitoring for CVEs is recommended for hypertensive diabetic patients with a nondipper BP pattern.
Abstract

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