Non-dipping pattern in untreated hypertensive patients is related to increased pulse wave velocity independent of raised nocturnal blood pressure

Figures & data

Table I. Clinical characteristics of untreated dipper and non-dipper hypertensive patients.

Groups, n (84)	Non-dipper (56)	Dipper (28)	p-value
Age (years)	52 ± 12	53 ± 10	NS
Gender (female, %)	55%	32%	0.045
BMI (kg/mŸ)	31 ± 5	31 ± 4	NS
SBP (mmHg), office measure	144 ± 18	143 ± 16	NS
DBP (mmHg), office measure	88 ± 11	89 ± 11	NS
Smoking, n (%)	24%	30%	NS
Diabetes mellitus	1%	1%	NS
Fast plasma glucose (mg/dl)	115 ± 42	112 ± 26	NS
Serum creatinine (mg/dl)	0.8 ± 0.3	0.8 ± 0.1	NS
Haemoglobin (mg/dl)	13.9 ± 1.5	14.4 ± 1.6	NS
Leukocytes (/mm^3)	8156 ± 2179	7635 ± 2953	NS
Platelets (10^3/mm^3)	273 ± 72	294 ± 79	NS
Total cholesterol (mg/dl)	217 ± 39	198 ± 51	NS
HDL-cholesterol (mg/dl)	49 ± 11	45 ± 9	NS
LDL-cholesterol (mg/dl)	139 ± 30	133 ± 49	NS
Triglycerides (mg/dl)	144 ± 52	141 ± 65	NS
CF-PWV (m/sn)	8.91 ± 2.53	7.66 ± 1.08	0.002
CF-PWV^a (m/sn)	9.45 ± 2.60	7.78 ± 0.98	< 0.001

BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; HDL, high-density lipoprotein; LDL, low-density lipoprotein; CF-PWV, carotid–femoral pulse wave velocity; NS, not significant. ^aConverted values according to the recent consensus (10,11).

Table II. Blood pressure measurements in untreated dipper and non-dipper hypertensive patients.

	Ambulatory BP measurements
Groups, n (84)	Non-dipper (56)	Dipper (28)	p-value
Blood pressure measurements
Total mean BP (mmHg)	109 ± 10	105 ± 9	0.094
Total SBP (mmHg)	141 ± 11	138 ± 11	NS
Total DBP (mmHg)	93 ± 10	90 ± 8	NS
Day mean BP (mmHg)	109 ± 10	109 ± 9	NS
Day SBP (mmHg)	142 ± 11	142 ± 12	NS
Day DBP (mmHg)	95 ± 10	94 ± 9	NS
Night mean BP (mmHg)	106 ± 11	92 ± 8	< 0.001
Night SBP (mmHg)	140 ± 14	125 ± 11	< 0.001
Night DBP (mmHg)	88 ± 10	78 ± 8	< 0.001
Day–night ratio	3.4 ± 6.3	15.4 ± 3.5	< 0.001
Heart rate parameters
Heart rate (beats/min), office measure	74 ± 11	72 ± 12	NS
Day heart rate (beats/min)	80 ± 9	77 ± 9	NS
Night heart rate (beats/min)	67 ± 9	65 ± 7	NS
Day-night heart rate ratio	16 ± 9	14 ± 9	NS

SBP, systolic blood pressure; DBP, diastolic blood pressure.

Table III. Multivariate logistic regression analysis: Predictors for non-dipping blood pressure pattern among individuals with essential hypertension.

	Dependent variable: non-dipper hypertensive pattern^a
Predictors	OR	95% CI	p-value
Age (years)	0.937	0.874–1.004	0.063
Gender (female, %)	5.112	1.282–20.38	0.021
Night mean BP (mmHg)	1.243	1.107–1.396	< 0.001
Total mean BP (mmHg)^b	1.05	0.988–1.115	0.115
Day mean BP (mmHg) ^b	1.004	0.952–1.059	0.873
CF-PWV (m/sn)	1.992	1.240–3.198	0.004
CF-PWV^c (m/sn)	2.306	1.286–4.137	0.005
Constant	0	0
R^2		0.617

CI, confidence interval; OR, odds ratio; ^aA decrease less than 10% in NBP was classified as “non-dipper hypertensive pattern” (lack of nocturnal decline). ^bWhen included. ^cConverted values according to the recent consensus (10,11).

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