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Analysis of Circadian Blood Pressure Patterns and Their Clinical, Metabolic, and Structural Correlates in Newly

Kaya Özen1, Süleyman Akkaya2

  • 1Department of Cardiology, Gazi Yasargil Training and Research Hospital, University of Health Sciences, 21070 Diyarbakır, Turkey.

Biomedicines
|July 28, 2026
PubMed

Insights

Advanced hypertension stages and disrupted blood pressure patterns are linked to metabolic issues and heart changes like left ventricular hypertrophy. Echocardiography and 24-hour blood pressure monitoring are key for detecting high-risk "reverse-dipper" patterns.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Echocardiography

Background:

  • Hypertension (HT) diagnosis and its association with metabolic and inflammatory markers require further investigation.
  • Circadian blood pressure patterns, including nocturnal dipping, are crucial indicators of cardiovascular risk.
  • Understanding the link between blood pressure stages, circadian patterns, and structural heart changes is vital for risk stratification.

Purpose of the Study:

  • To investigate the relationships between American Heart Association/American College of Cardiology (AHA/ACC) blood pressure stages and circadian blood pressure patterns.
  • To assess associations with clinical, metabolic, inflammatory, and echocardiographic parameters in newly diagnosed hypertensive patients.
  • To identify independent predictors of high-risk circadian blood pressure disruptions.

Main Methods:

  • Retrospective analysis of 539 newly diagnosed hypertensive patients undergoing 24-hour Ambulatory Blood Pressure Monitoring (ABPM).
  • Patients were categorized by nocturnal blood pressure dipping percentages and HT stages.
  • Evaluation of laboratory markers (TyG index, AIP, SII, AISI, NLR) and echocardiographic data using multivariable logistic regression.

Main Results:

  • Progressing HT stages correlated with increased metabolic risk indicators (TyG index, AIP).
  • Prevalence of left ventricular hypertrophy (LVH) significantly increased with HT stage, reaching 34.5% in Stage 2 HT.
  • Left atrial diameter (LAd) was identified as a common independent predictor of circadian disruption, particularly in 'reverse-dipper' patterns, alongside LVH.

Conclusions:

  • Advanced HT stages and disrupted circadian rhythms are strongly linked to metabolic impairment, left atrial dilatation, and LVH.
  • Left atrial diameter and LVH are significant independent predictors of the high-risk 'reverse-dipper' pattern.
  • Echocardiographic screening and ABPM are essential for early detection of adverse circadian patterns in hypertensive patients with cardiac structural changes.

Keywords:
atherogenic index of plasmacircadian blood pressurehypertensionleft atrial diameterleft ventricular hypertrophytriglyceride–glucose index

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