A 25-year longitudinal study on dipping/nondipping tracking in the general population: the PAMELA study

Area of Science:

• Cardiology
• Hypertension Research
• Chronobiology

Background:

• Long-term reproducibility of nighttime blood pressure (BP) phenotypes, dipping (D) and nondipping (ND), is not well-established in population studies.
• The PAMELA study prospectively collected clinical, laboratory, ambulatory BP monitoring (ABPM), and target organ damage data over 25 years.

Purpose of the Study:

• To investigate the long-term reproducibility of nighttime BP phenotypes (D and ND) over a 25-year period.
• To assess the association between persistent and occasional nighttime BP phenotypes and markers of target organ damage.

Main Methods:

• Analysis of 541 participants from the PAMELA study with data from initial, 10-year, and 25-year follow-up surveys.
• Nondipping (ND) pattern defined as night-time systolic BP reduction <10% compared to daytime values.
• Assessment of cardiac and vascular end-organ damage markers.

Main Results:

• 37.15% of participants with a dipping (D) pattern at baseline maintained it over 25 years (persistent D).
• Only 5.7% of participants exhibited a persistent nondipping (ND) pattern over the 25-year follow-up.
• No significant differences in cardiac and vascular end-organ damage markers were found between persistent/prevalent ND and occasional ND/persistent D phenotypes after risk factor adjustment.

Conclusions:

• Nocturnal BP phenotypes demonstrate poor long-term reproducibility, with persistent ND being very uncommon.
• The association between persistent vs. occasional nighttime BP phenotypes and target organ damage requires further investigation in larger cohorts.