Increased plasma lactate level is associated with subclinical cardiovascular damage in patient with non-dipping hypertension

ABSTRACT

Objective: To evaluate the difference of plasma lactate level between dipping and non-dipping hypertension, and to investigate the effects of lactate on subclinical cardiovascular damages in dipping and non-dipping hypertension. Methods: According to 24 h ambulatory blood pressure monitoring, 236 patients with dipping and 152 with non-dipping hypertension were included. Clinical characteristics were collected and compared between dipping and non-dipping groups. Left ventricle hypertrophy (LVH) and N-terminal pro-B type natriuretic peptide (NT-proBNP) level were used to evaluate subclinical cardiovascular damage. Multivariate regression analysis was performed to evaluate the relationship between lactate and LVH and NT-proBNP elevation. Results: Compared to dipping hypertension, plasma levels of lactate and NT-proBNP in non-dipping hypertension group were significantly higher. Moreover, the value of left ventricle mass index to height (LVMI/height) was also significantly higher in non-dipping group, and the percentage of patient with LVH was also higher in non-dipping group (36.8% vs. 28.9%, P < 0.05). Multivariate regression analysis revealed that in non-dipping group, after fully adjustment, the associations between lactate with LVH and NT-proBNP remained significant, with odds ratio (OR) of 1.18 (95% confidence interval [CI] of 1.13–1.24) in LVH and OR of 1.16 in NT-proBNP (95% CI of 1.10–1.23), respectively. Nonetheless, the associations between lactate with LVH and NT-proBNP elevation in dipping group were diminished to statistical nonsignificance. Conclusion: Plasma lactate level in non-dipping hypertension is significantly higher than dipping hypertension, and this difference may be the potential mechanism non-dipping hypertension contributes to greater targeted organ damage.

KEYWORDS:

• Dipping hypertension
• lactate
• non-dipping hypertension
• relationship
• targeted organ damage

Acknowledgments

We are indebted to Dr. DongDan Zheng for helping us to improve the writing of our paper.

Declaration of interest

The authors declare that they have no competing interests.