Relation between nocturnal decline in blood pressure and choroidal thickness: a comparative analysis in dipper vs.
Sedat Tas1, Muhammed Altinisik2, Ümmü Tas3
1Cardiology Department, Manisa City Hospital.
Insights
Hypertension patients who do not experience a significant drop in blood pressure at night (non-dippers) may have thinner choroids. This finding in non-dipper hypertension may be linked to longer disease duration and higher blood pressure levels.
Area of Science:
- Ophthalmology
- Cardiology
- Hypertension Research
Background:
- Systemic arterial hypertension (HT) is associated with various cardiovascular and ocular complications.
- Nocturnal blood pressure dipping patterns (dipper vs. non-dipper) may reflect differential cardiovascular risk and organ damage.
Purpose of the Study:
- To investigate differences in choroidal thickness (ChT) and echocardiographical parameters between dipper and non-dipper patients with systemic arterial hypertension.
Main Methods:
- Patients with HT were categorized into dipper and non-dipper groups based on 24-hour ambulatory blood pressure monitoring.
- Transthoracic echocardiography was performed, and choroidal thickness (ChT) was measured using spectral-domain optical coherence tomography at subfoveal, nasal, and temporal locations.
Main Results:
- Non-dipper hypertensive patients exhibited significantly lower subfoveal and temporal ChT compared to dippers.
- The non-dipper group showed higher left atrial volume index (LAVI) and pulmonary valve maximum flow (PV-max).
- Night-time systolic blood pressure (SBP) was negatively correlated with ChT and positively correlated with LAVI and PV-max, though these correlations lost significance after adjusting for confounding factors.
Conclusions:
- Non-dipper hypertension is associated with reduced choroidal thickness, potentially due to longer disease duration and elevated ambulatory blood pressure levels.
- These findings suggest that nocturnal blood pressure patterns may influence ocular microvascular integrity in hypertensive individuals.
Purpose:
To compare choroidal thickness (ChT) and echocardiographical changes in patients with dipper and non-dipper systemic arterial hypertension (HT).
Methods:
Patients with HT were evaluated in two groups according to the 24-hour ambulatory BP monitoring. Compared to day-time values, those whose night-time SBP decreased ≥10% were defined as dippers, and those whose SBP decreased <10% were defined as non-dippers. Transthoracic echocardiography was conducted in all patients. ChT and central macular thickness were measured with spectral-domain optical coherence tomography. ChT was obtained at the subfoveal, 1500 µm nasal and temporal to the fovea.
Results:
Thirty non-dipper (18 females and 12 males) and 23 dipper (16 females and seven males) hypertensive patients were recruited. Sex distribution and the mean age were similar between the groups (P = 0.472; P = 0.12). Disease duration was longer in the non-dipper group (8 ± 3.39 vs. 4.96 ± 1.19 years, P = 0.001). The non-dipper group had lower ChT in subfoveal and temporal locations (P = 0.02 and 0.03, respectively) and higher left atrial volume index (LAVI) and pulmonary valve maximum flow (PV-max; P < 0.001). The night-time SBP was negatively correlated with ChT (P = 0.048) and positive correlated with LAVI and PV-max (P < 0.05). However those correlations were not significant when were controlled by the possible confounding factors as disease duration, age and gender.
Conclusion:
Non-dipper HT patients may have thinner choroid than dippers due to longer duration of HT and higher ambulatory BP levels.
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