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Blood pressure reverse dipping may associate with stable coronary artery disease in patients with essential
1Department of Emergency Medicine, the Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
Insights
Hypertensive patients with reverse blood pressure (BP) dipping, where nighttime BP is higher than daytime BP, show a higher prevalence of stable coronary artery disease (sCAD). This BP pattern may indicate underlying sCAD.
Area of Science:
- Cardiology
- Hypertension Research
- Circadian Rhythms
Background:
- Circadian blood pressure (BP) variations are linked to target-organ damage and cardiovascular events.
- The 'reverse dipping' BP pattern, characterized by higher nocturnal systolic BP than daytime BP, is a significant concern.
Purpose of the Study:
- To investigate the association between the reverse dipping BP pattern and the prevalence of stable coronary artery disease (sCAD) in hypertensive individuals.
- To identify independent risk factors for sCAD in this population.
Main Methods:
- A study involving 718 hypertensive patients from a single center in Northern China.
- Utilized 24-hour ambulatory BP monitoring (ABPM) to assess BP patterns, including reverse dipping.
- Employed logistic regression models for multivariate analysis to determine independent risk factors.
Main Results:
- Patients with reverse BP dipping were more prevalent in the sCAD group (31.5%) compared to the control group (19.5%).
- Reverse BP dipping was independently associated with the prevalence of sCAD (Odds Ratio [OR], 1.772; p=0.027).
- A reduced circadian decline rate of systolic BP was also independently associated with sCAD (OR, 0.975; p=0.043).
Conclusions:
- Hypertensive patients exhibiting a reverse BP dipping pattern are more frequently diagnosed with sCAD.
- 24-hour ABPM assessment of reverse BP dipping may serve as an indicator for the presence of sCAD.
Abstract:
The dipping variations of circadian blood pressure (BP) correlate closely with target-organ damages and cardiovascular events. The aim of this study was to investigate the relationship between BP reverse dipping and the prevalence of stable coronary artery disease (sCAD) in hypertensive patients. Clinical data and the results of 24-hour ambulatory BP monitoring (ABPM) were obtained from 718 hypertensive patients (390 males, mean age 59.6 ± 13.8 years) in a single centre in Northern China. Reverse dipping pattern was defined as nocturnal systolic BP (SBP) was higher than daytime SBP. A logistic regression model was applied to explore the independent risk factors of sCAD. The patients with BP reverse dipping accounted for 31.5% in sCAD group and 19.5% in control group (P < 0.05). In multivariate analysis, BP reverse dipping remained significantly associated with the prevalence of sCAD (Odds ratio [OR], 1.772; p = 0.027). Furthermore, the circadian decline rate of SBP was independently associated with sCAD (OR, 0.975; p = 0.043). The hypertensive patients with reverse BP dipping were found to be more frequently suffering from sCAD. BP reverse dipping examined with 24-hour ABPM may indicate sCAD.
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