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Association between non-dipper blood pressure pattern and coronary artery disease burden in hypertensive patients

Ozkan Bekler1, Alparslan Kurtul2

  • 1Department of Cardiology, Istanbul Medipol University, Istanbul, Turkey.

Expert Review of Cardiovascular Therapy
|October 8, 2025
PubMed

Insights

Non-dipper blood pressure patterns are linked to more complex coronary artery disease (CAD) in hypertensive patients. This finding may improve cardiovascular risk assessment and prevention strategies.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Medicine

Background:

  • Non-dipper blood pressure (BP) patterns are linked to increased cardiovascular risk.
  • The association between non-dipper BP and coronary artery disease (CAD) complexity is not well understood.

Purpose of the Study:

  • To investigate the relationship between non-dipper BP and CAD complexity in hypertensive patients.
  • To assess CAD burden using SYNTAX Scores (SS) I and II.

Main Methods:

  • Prospective enrollment of 381 hypertensive patients undergoing coronary angiography.
  • 24-hour ambulatory BP monitoring (ABPM) to classify patients as dipper or non-dipper.
  • CAD complexity assessed by SS I and II, with ROC analysis and logistic regression.

Main Results:

  • Non-dippers exhibited significantly higher SS I and SS II compared to dippers (p < 0.001).
  • SS II demonstrated greater predictive value (AUC: 0.704).
  • Non-dipper status, diabetes, lower eGFR, and higher platelet count were independent predictors of high SS.

Conclusions:

  • Non-dipper BP is independently associated with greater anatomical and clinical CAD complexity.
  • Integrating ABPM and SS can enhance cardiovascular risk stratification.
  • Findings may inform personalized preventive strategies for hypertensive patients.
Abstract

Keywords:
ABPMCADNocturnal hypertensionSYNTAX scoreambulatory blood pressure monitoringcoronary artery diseasehypertensionnon-dipper blood pressure

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