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Clinical correlates and subclinical cardiac organ damage in different extreme dipping patterns

Cesare Cuspidi1,2, Rita Facchetti1, Fosca Quarti-Trevano1

  • 1Department of Medicine and Surgery, University of Milano-Bicocca.

Journal of Hypertension
|January 25, 2020
PubMed

Insights

The extreme dipping blood pressure pattern is common in the general population. This blood pressure phenotype is not associated with increased cardiac organ damage in individuals without prevalent cardiovascular disease.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Phenotyping

Background:

  • Hypertension-mediated organ damage (HMOD) associations with extreme dipping are not well-established.
  • The Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study provides a general population dataset to investigate this.
  • Understanding blood pressure phenotypes is crucial for cardiovascular risk assessment.

Purpose of the Study:

  • To evaluate the clinical correlates of the extreme dipping blood pressure pattern.
  • To determine the relationship between extreme dipping and cardiac HMOD in the general population.

Main Methods:

  • Analysis of participants from the PAMELA study with ambulatory blood pressure monitoring (ABPM) and echocardiography.
  • Categorization of participants into extreme dippers (systolic/diastolic), dippers, and non-dippers.
  • Assessment of left ventricular mass (LVM) and left ventricular hypertrophy (LVH) as indicators of cardiac HMOD.

Main Results:

  • Nearly half of the participants (49.6%) exhibited an extreme dipping pattern.
  • Prevalence rates of LVH and increased LVM increased progressively from extreme dippers to non-dippers before adjustment.
  • After adjusting for confounders, no significant differences in LVMI or LVH rates were found among the four blood pressure dipping groups.

Conclusions:

  • The extreme dipping blood pressure pattern is a frequent phenotype in the general population, particularly in middle-aged individuals without prior cardiovascular disease.
  • In this population, the extreme dipping pattern is not linked to an elevated risk of cardiac HMOD.
  • Potential adverse cardiovascular mechanisms associated with extreme dipping may not be active in this context.
Abstract

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