Nocturnal Hypertension Correlates Better With Target Organ Damage in Patients With Chronic Kidney Disease than a Nondipping Pattern

Wang, Cheng; Deng, Weiming; Gong, Wen Yu; Zhang, Jun; Zhang, Qun Zi; Ye, Zeng Chun; Lou, Tanqi

doi:10.1111/jch.12589

Cited by 22 publications

(45 citation statements)

References 32 publications

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“…Ultrasonographic assessment of cardiac and carotid damage associated with NH pattern was the primary aim of all studies. Participants had been recruited from hypertensive cohort, population‐based sample, type 2 diabetic and chronic kidney disease settings …”

Section: Resultsmentioning

confidence: 99%

“…Brachial clinic BP was measured according to recommendations of contemporary international guidelines. Mercury sphygmomanometers were used in three studies and an oscillometric device in one The remaining studies did not provide any information on the type of device used. Of note, clinic BP was determined by taking multiple measurements during at least two visits in three studies …”

Section: Resultsmentioning

confidence: 99%

“…Ambulatory BP was measured on the nondominant arm using validated devices in all studies. A Spacelabs 90207 device (Spacelabs, Redmond, WA) was used in six of seven studies, and a Takeda device (TM 2430, Tokyo, Japan) was used in the remaining study . Instruments were set to take BP readings at different time intervals (15–20 minutes during daytime and 15–30 minutes during nighttime).…”

Section: Resultsmentioning

confidence: 99%

“…Nocturnal hypertension was defined as a mean nighttime systolic and/or diastolic BP ≥120/70 mm Hg in five studies, and as a mean nighttime systolic BP ≥120 mm Hg in two studies …”

Section: Resultsmentioning

confidence: 99%

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Nocturnal Hypertension and Subclinical Cardiac and Carotid Damage: An Updated Review and Meta‐Analysis of Echocardiographic Studies

Cuspidi

Sala

Tadić

et al. 2016

J of Clinical Hypertension

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Evidence on the association of nocturnal hypertension (NH) with subclinical cardiac and vascular damage is scanty. The authors performed a meta-analysis to provide comprehensive information on this clinically relevant issue. Full articles providing data on subclinical cardiac and carotid damage as assessed by ultrasonographic methods in patients with NH as compared with patients with nocturnal normotension (NN) were considered. A total of 3657 patients (NH=2083, NN=1574) of both sexes were included in seven studies. A growing body of evidence indicates that nighttime blood pressure (BP) is more closely related to subclinical organ damage and cardiovascular prognosis than 24-hour and daytime BPs.1 A mounting body of evidence also indicates that nighttime BP is a better predictor of alterations in target organs and cardiovascular events than the nondipping pattern.2,3 The clinical value of the dipping/nondipping classification has been questioned based on pathophysiological and methodological considerations. First, dipping/nondipping categorization is strongly dependent on daytime BP values, which, in turn, are related to multiple variables including degree of physical activity, emotional state, coffee/ alcohol drinking, smoking habit, and seasonal variability.4,5 Second, both dipping and nondipping patterns have been shown to have a limited reproducibility over short-and long-term periods in the setting of essential hypertension.6,7 Third, dipping pattern is not synonymous with normal nighttime BP, as it may be associated with nocturnal hypertension (NH) according to current hypertension guideline cutoffs (ie, BP >120/70 mm Hg). 8 NH has been reported to convey a higher risk of vascular and cardiac morphofunctional alterations as well as of nonfatal and fatal cardiovascular events and all-cause mortality regardless daytime BP values.Findings from the International Database of Ambulatory Blood Pressure involving 8711 individuals from 10 populations showed that patients with isolated NH (ie, daytime BP <135/85 mm Hg and nighttime BP ≥120/70 mm Hg) exhibited higher risks of total mortality (+29%, P=.04) and all cardiovascular events (+38%, P=.003) compared with their counterparts with nocturnal normotension (NN). 9 The stronger predictive value of nocturnal systolic BP over daytime BP has been documented by a review of 24 prospective studies including 23,856 hypertensive patients and 9641 individuals from population-based cohorts.10 Furthermore, among 859 diabetic patients followed-up for 5 years in the Dublin Outcome Study, nighttime systolic BP was a powerful independent predictor of cardiovascular mortality, after adjustment for age, sex, body mass index (BMI), smoking, previous cardiovascular disease, and daytime BP.11 The resultant hazard ratios and 95% confidence intervals (CIs) associated with a 10-mm Hg increase in systolic nighttime BP were 1.32 (CI, 1.12-1.69), 1.95 (CI,, and 1.24 (CI, 0.99-1.56) for total cardiovascular events, stroke, and cardiac mortality, respectively. Notably, the fully adjusted 5-yea...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Nocturnal hypertension was defined as a mean nighttime systolic and/or diastolic BP ≥120/70 mm Hg in five studies, and as a mean nighttime systolic BP ≥120 mm Hg in two studies …”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Nocturnal Hypertension and Subclinical Cardiac and Carotid Damage: An Updated Review and Meta‐Analysis of Echocardiographic Studies

Cuspidi

Sala

Tadić

et al. 2016

J of Clinical Hypertension

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show abstract

“…Cuspidi et al 10 reported no difference in CIMT or plaques between those with nocturnal normotension and nocturnal hypertension. However, Wang et al 51 reported an association between nocturnal hypertension and CIMT in patients with chronic kidney disease. Cuspidi et al 52 have recently reported the results of a meta-analysis that examined the association of nondipping with carotid atherosclerosis and found higher CIMT and greater prevalence of plaques in nondippers.…”

Section: Discussionmentioning

confidence: 99%