Nocturnal systolic hypertension is a risk factor for cardiac damage in the untreated masked hypertensive patients

Li, Jianhao; Cao, Yalin; Liu, Chen; Li, Jiayong; Yao, Fengjuan; Dong, Yugang; Huang, Huiling

doi:10.1111/jch.13711

Cited by 4 publications

(2 citation statements)

References 43 publications

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“…Several other studies, summarized in Table 2, also highlight the importance of nighttime BP level as a risk factor for cardiac remodeling. [35][36][37][38][39][40][41][42] Overall, the data from these studies suggest that both a nondipper profile of nighttime BP and elevated nighttime BP appear to be important risk factors for the development of cardiac remodeling and hypertrophy, independent of overall ambulatory BP levels.…”

Section: Association Between Nighttime Bp/ Nocturnal Dipping Status A...mentioning

confidence: 99%

Nocturnal Hypertension and Heart Failure: Mechanisms, Evidence, and New Treatments

Kario

Williams

2021

Hypertension

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Heart failure (HF) is a common condition with an increasing prevalence. Despite a variety of evidence-based treatments for patients with HF with reduced ejection fraction, morbidity and mortality rates remain high. Furthermore, there are currently no treatments that have yet been shown to reduce complication and death rates in patients who have HF with preserved ejection fraction. Hypertension is a common comorbidity in patients with HF, contributing to disease development and prognosis. For example, hypertension is closely associated with the development of left ventricular hypertrophy, which an important precursor of HF. In particular, nighttime blood pressure (BP) appears to be an important, modifiable risk factor. Both nighttime BP and an abnormal circadian pattern of nighttime BP dipping have been shown to predict development of HF and the occurrence of cardiovascular events, independent of office BP. Key mechanisms for this association include sodium handling/salt sensitivity and increased sympathetic activation. These pathogenic mechanisms are targeted by several new treatment options, including sodium-glucose cotransporter 2 inhibitors, angiotensin receptor neprilysin inhibitors, mineralocorticoid receptor antagonists, and renal denervation. All of these could form part of antihypertensive strategies designed to control nighttime BP and contribute to the goal of achieving perfect 24-hour BP management. Nevertheless, additional research is needed to determine the effects of reducing nighttime BP and improving the circadian BP profile on the rate of HF, other cardiovascular events, and mortality.

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Section: Association Between Nighttime Bp/ Nocturnal Dipping Status A...mentioning

confidence: 99%

Nocturnal Hypertension and Heart Failure: Mechanisms, Evidence, and New Treatments

Kario

Williams

2021

Hypertension

View full text Add to dashboard Cite

show abstract

“…Ambulatory blood pressure monitoring (ABPM) can provide 24 h BP data comprehensively, including daytime BP, nighttime BP, and the BP circadian rhythm. Disruption of the BP circadian rhythm and nocturnal hypertension have been revealed to be an important contribution to target organ damage (TOD) and many adverse cardiovascular events in hypertension (5)(6)(7)(8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Association of Nighttime Systolic Blood Pressure With Left Atrial-Left Ventricular–Arterial Coupling in Hypertension

Sun

Zhao

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveHypertension (HT) induces left atrial (LA) and left ventricular (LV) dysfunction, and an increase in arterial stiffness. In this study, we investigated the association between LA-LV–arterial coupling and nighttime systolic blood pressure (BP) as well as BP circadian rhythm in essential hypertension.MethodsWe enrolled 290 HT patients. All subjects were evaluated by 2- dimensional speckle tracking echocardiography (2DSTE), ambulatory 24 h BP monitoring (ABPM), and brachial–ankle pulse wave velocity (PWV). According to BP patterns, these patients were divided into two groups, which included dippers (n = 111), patients with a >10% reduction in BP at nighttime; non-dippers (n = 179), patients with a <10% reduction in BP at nighttime. 2D-STE based LA and LV strains were studied and the following parameters were measured, LV global longitudinal strain (GLS), LA reservoir strain (LAS−S), LA conduit strain (LAS−E), and LA booster pump strain (LAS−A). LA stiffness index (LASI) defined as the ratio of E/e′ to LAS−S, and PWV-to-GLS ratio (PWV/GLS) were calculated to reflect LA-LV–arterial coupling. Furthermore, we also explored the correlation between LASI (or PWV/GLS) and ambulatory blood pressure indexes.ResultsLeft atrial stiffness index was significantly higher in non-dippers [0.29 (0.21, 0.41)] than in dippers [0.26 (0.21, 0.33)] (P < 0.05). PWV/GLS was significantly higher in non-dippers [−80.9 (−69.3, −101.5)] than in dippers [−74.2 (−60.2, −90.6)] (P < 0.05). LAS−S, LAS−E, LAS−A,and LV GLS were significantly lower in non-dippers than in dippers (P < 0.05). Multivariate linear regression analysis revealed that nighttime systolic BP was independently correlated with LASI and PWV/GLS, even adjusted for multiple clinical risk factors, LVMI, and LVEF.ConclusionsThe dipping pattern of BP was related to the abnormalities of myocardial mechanics and LA-LV–arterial coupling. However, absolute nocturnal systolic BP value maybe more important than BP circadian profile in the progression of abnormal LA-LV–arterial coupling.

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Maternal History of Adverse Childhood Experiences and Ambulatory Blood Pressure in Pregnancy

et al. 2020

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Objective This study aimed to study the association between maternal history of childhood adversity and blood pressure in pregnancy. Methods A total of 127 pregnant women completed measures of adverse childhood experiences (ACE) and prenatal stress between June 2015 and April 2019. At 11 weeks’ gestation (range, 6–17 weeks), we measured 24-hour ambulatory blood pressure. All women were considered to be at risk for pregnancy complications due to elevated body mass index and self-reporting snoring in pregnancy. Results Women were, on average, 30 years old (range, 19–40 years), and average (standard deviation) body mass index in this sample was 34 (7) kg/m2 (range, 27–55 kg/m2). Higher ACE scores were associated with higher nighttime blood pressure (systolic blood pressure: β = 0.23, p = .013; diastolic blood pressure: β = 0.22, p = .028). There were no significant associations between the ACE score and daytime blood pressure. Women with four or more ACEs were more likely to display nocturnal blood pressure nondipping (odds ratio = 3.97, 95% confidence interval = 1.38–11.40). Associations between ACE and nocturnal blood pressure remained significant after adjusting for symptoms of prenatal stress. Conclusions Results indicate that experiences of childhood adversity are associated with elevated nocturnal blood pressure and loss of a typical decline in blood pressure between day and night.

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Nocturnal systolic hypertension is a risk factor for cardiac damage in the untreated masked hypertensive patients

Cited by 4 publications

References 43 publications

Nocturnal Hypertension and Heart Failure: Mechanisms, Evidence, and New Treatments

Nocturnal Hypertension and Heart Failure: Mechanisms, Evidence, and New Treatments

Association of Nighttime Systolic Blood Pressure With Left Atrial-Left Ventricular–Arterial Coupling in Hypertension

Maternal History of Adverse Childhood Experiences and Ambulatory Blood Pressure in Pregnancy

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