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Circadian Blood Pressure Profile and Associated Cardiovascular Risk Factors in Prehypertensive Patients and Its
Jaldu Krishna Pavan1, Ashok Kumar2, Gutti Prasanth1
1Resident, Department of General Medicine, Santosh Medical College, Santosh Deemed to be University, Ghaziabad, Uttar Pradesh, India.
Insights
Prehypertension circadian blood pressure patterns are linked to kidney markers and inflammation. Nondippers, those with abnormal nighttime blood pressure reduction, show higher urinary albumin-to-creatinine ratio (UACR) and C-reactive protein (CRP), indicating increased cardiovascular risk.
Area of Science:
- Cardiology
- Nephrology
- Hypertension Research
Background:
- Prehypertension (systolic blood pressure 120-139 mmHg, diastolic blood pressure 80-89 mmHg) precedes hypertension and elevates cardiovascular risk.
- Circadian blood pressure (BP) patterns and dipper status are crucial indicators of cardiovascular health.
- Urinary albumin-to-creatinine ratio (UACR) serves as a marker for kidney and vascular damage.
Purpose of the Study:
- To investigate the circadian BP patterns in prehypertensive individuals.
- To examine the relationship between dipper status, UACR, and other cardiovascular risk factors.
- To identify early markers for increased cardiovascular risk in prehypertension.
Main Methods:
- Systematic observation of 101 participants, with 57.4% identified as prehypertensive.
- Classification of prehypertensive participants into dippers (>10% nocturnal BP reduction) and nondippers (<10% nocturnal BP reduction).
- Measurement of UACR, high-sensitivity C-reactive protein (Hs-CRP), lipid profiles, and biochemical parameters; statistical analysis using t-tests and ANOVA.
Main Results:
- Prehypertensive subjects exhibited significantly higher 24-hour SBP and DBP compared to normotensive controls (p < 0.001).
- Nondippers (55.2% of prehypertensives) showed elevated nighttime SBP and DBP (p < 0.001).
- Significant correlation found between UACR and nondipper status (p = 0.034); nondippers also had higher Hs-CRP levels, indicating inflammation.
Conclusions:
- Circadian BP variability and dipper status in prehypertension are associated with UACR and Hs-CRP.
- Nondippers in the prehypertensive group may face a higher cardiovascular risk.
- Ambulatory blood pressure monitoring (ABPM) is valuable for identifying at-risk prehypertensive individuals needing closer monitoring and intervention.
Background:
Prehypertension is characterized by a systolic blood pressure (SBP) ranging from 120 to 139 mm Hg and a diastolic blood pressure (DBP) between 80 and 89 mm Hg, acting as a precursor to hypertension and potentially increasing cardiovascular risks. This study investigates the circadian patterns of blood pressure (BP), dipper status, and associated cardiovascular risk factors in prehypertensive individuals, with a particular focus on the relationship with the urinary albumin-to-creatinine ratio (UACR) as a marker of kidney and vascular health.
Objective:
To assess the circadian rhythm of BP in prehypertensive patients and examine its relationship with UACR and other cardiovascular risk factors.
Methods:
In this research involving systematic observation, a total of 101 participants were included, 57.4% of whom were identified as prehypertensive. Prehypertensive participants were grouped into "dippers" or "nondippers" based on a nocturnal BP reduction threshold of greater than or <10%, respectively. UACR, high-sensitivity C-reactive protein (Hs-CRP), lipid profiles, and additional biochemical parameters were measured. Statistical analysis included t-tests and analysis of variance (ANOVA) were utilized to examine associations.
Results:
Prehypertensive subjects demonstrated significantly higher mean 24-hour SBP and DBP than normotensive controls (p < 0.001). Dipper status was identified in 55.2% of prehypertensives, with nondippers exhibiting elevated nighttime SBP and DBP (p < 0.001). UACR and nondipper status were found to be significantly correlated (p = 0.034), with nondippers also displaying elevated Hs-CRP levels, indicating greater systemic inflammation.
Conclusion:
Circadian BP variability and dipper status in prehypertensive patients correlate with UACR and Hs-CRP levels, suggesting that nondippers may be at increased cardiovascular risk. Ambulatory blood pressure monitoring (ABPM) offers valuable insights into early hypertension risk and can aid in identifying prehypertensive individuals requiring closer monitoring and intervention.
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