Blood pressure reverse dipping may associate with stable coronary artery disease in patients with essential hypertension: a cross-sectional study

Abstract

The dipping variations of circadian blood pressure (BP) correlate closely with target-organ damages and cardiovascular events. The aim of this study was to investigate the relationship between BP reverse dipping and the prevalence of stable coronary artery disease (sCAD) in hypertensive patients. Clinical data and the results of 24-hour ambulatory BP monitoring (ABPM) were obtained from 718 hypertensive patients (390 males, mean age 59.6 ± 13.8 years) in a single centre in Northern China. Reverse dipping pattern was defined as nocturnal systolic BP (SBP) was higher than daytime SBP. A logistic regression model was applied to explore the independent risk factors of sCAD. The patients with BP reverse dipping accounted for 31.5% in sCAD group and 19.5% in control group (P < 0.05). In multivariate analysis, BP reverse dipping remained significantly associated with the prevalence of sCAD (Odds ratio [OR], 1.772; p = 0.027). Furthermore, the circadian decline rate of SBP was independently associated with sCAD (OR, 0.975; p = 0.043). The hypertensive patients with reverse BP dipping were found to be more frequently suffering from sCAD. BP reverse dipping examined with 24-hour ABPM may indicate sCAD.

Ambulatory Blood Pressure Monitoring in Type 2 Diabetes Mellitus: A Cross-sectional Study

“…Studies have demonstrated that non or reverse dipping [18-23] and nocturnal HT [11, 12] are associated with diabetic complications and adverse cardiovascular outcomes. Fogari et al demonstrated that non-dipping was independently associated with microalbuminuria [24].…”

Clinical and prognostic significance of a reverse dipping pattern on ambulatory monitoring: An updated review

“…In a retrospective case‐control study including 189 hypertensive patients with spontaneous intracerebral hemorrhage and 182 hypertensive controls, Sun and colleagues documented that RD pattern was much more prevalent in cases (51%) than in controls (4%). The association between RD and coronary artery disease has been evaluated in a hypertensive cohort of 267 patients with and 461 patients without stable coronary artery disease . The authors reported that this abnormal BP phenotype was 1.6‐fold more prevalent in the former than in the latter group.…”

“…The association between RD and coronary artery disease has been evaluated in a hypertensive cohort of 267 patients with and 461 patients without stable coronary artery disease. 42 The authors reported that this abnormal BP phenotype was 1.6-fold more prevalent in the former than in the latter group. In multivariate logistic regression analysis, RD (HR,…”

Visceral fat, cardiometabolic risk factors, and nocturnal blood pressure fall in young adults with primary hypertension

“…Although routine antihypertensive medications seem not to influence DXA‐derived body composition, some of them may alter insulin sensitivity, glucose tolerance, and lipid profiles (eg, with thiazide diuretics) or sympathetic activity (with β‐blockers and α 1 ‐blockers). Thirdly, we defined a non‐dipping blood pressure profile based solely on SBP as in some previous reports . However, other studies have used both the SBP and DBP day‐to‐night differences for defining non‐dippers .…”