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Blood Pressure Patterns and Hepatosteatosis: Cardiometabolic Risk Assessment in Dipper and Non-Dipper Phenotypes
Ramazan Astan1, Dimitrios Patoulias2,3, Ana Ninić4
1Department of Cardiology, Batman Training and Research Hospital, Batman 72000, Türkiye.
Insights
Non-dipper hypertension, where blood pressure remains high at night, is linked to increased hepatosteatosis (fatty liver) and uric acid levels. Monitoring metabolic disorders is crucial for managing this condition.
Area of Science:
- Cardiology
- Hepatology
- Metabolic Disorders
Background:
- Non-dipper hypertension (HT) signifies inadequate nocturnal blood pressure dipping, increasing cardiovascular and organ damage risks.
- Understanding associations between blood pressure patterns, hepatosteatosis, and metabolic markers is vital for hypertensive and normotensive individuals.
Purpose of the Study:
- To investigate the relationship between dipper/non-dipper blood pressure patterns, hepatosteatosis, and biochemical markers.
- To compare these factors in both hypertensive and normotensive patient groups.
Main Methods:
- Retrospective and cross-sectional analysis of 142 patients' demographic, biochemical, and hepatic ultrasonography data.
- 24-hour ambulatory blood pressure measurement (ABPM) categorized patients into four groups: non-dipper normotensive (NDN), dipper normotensive (DN), non-dipper hypertensive (NDH), and dipper hypertensive (DH).
Main Results:
- Non-dipper hypertensive (NDH) individuals exhibited significantly higher levels of hepatosteatosis and uric acid compared to dipper hypertensive (DH) and normotensive groups (p < 0.001).
- Hepatosteatosis grade demonstrated strong discriminatory power (AUC 0.861) for identifying non-dipper hypertensive patients.
- Hypertensive individuals with a non-dipper pattern showed a higher prevalence of hepatosteatosis and elevated uric acid.
Conclusions:
- Non-dipper blood pressure patterns are associated with a heightened risk of cardiometabolic diseases.
- Effective management of non-dipper hypertension requires monitoring and treatment of both blood pressure and co-existing metabolic disorders like hepatosteatosis.
Abstract:
Background/Objectives: Non-dipper hypertension (HT), a condition in which blood pressure does not drop sufficiently at night compared to daytime, is considered a serious condition that increases the risk of cardiovascular disease, stroke, and organ damage. This study aimed to examine the relationship between dipper and non-dipper blood pressure patterns, hepatosteatosis, and biochemical markers in hypertensive and normotensive individuals. Methods: Demographic, biochemical, and hepatic ultrasonography data from 142 patients who underwent 24 h ambulatory blood pressure measurement (ABPM) were evaluated retrospectively and cross-sectionally in this study. Patients were categorized into four groups based on ABPM results: non-dipper normotensive (NDN), dipper normotensive (DN), non-dipper hypertensive (NDH), and dipper hypertensive (DH). Results: The study results indicate that NDH individuals had markedly elevated levels of hepatosteatosis and uric acid compared with DH and normotensive persons (p < 0.001). The grade of hepatosteatosis showed significant discriminatory capacity in differentiating between dipper and non-dipper hypertensive patients, with an AUC of 0.861, specificity of 94%, and sensitivity of 66%. Individuals with hypertension exhibiting a non-dipper pattern demonstrate a greater prevalence of hepatosteatosis and elevated uric acid levels. Conclusions: The study findings show non-dipper patterns have a higher risk for cardiometabolic diseases. This indicates that not only blood pressure, but also metabolic disorders should be closely monitored and treated in the management of non-dipper HT.
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