Abstract: PUB426
Examining Circadian Blood Pressure Patterns: Investigating the Interplay between Dipper Status and Arterial Stiffness Metrics
Session Information
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Nam, Chanwoo, MedStar Georgetown University Hospital Nephrology Services, Washington, District of Columbia, United States
- Pourafshar, Negiin, MedStar Georgetown University Hospital Nephrology Services, Washington, District of Columbia, United States
Background
Compared with dippers, hypertensive individuals with a nondipping nocturnal blood pressure (BP) pattern, often present with heightened target organ damage and a bleaker cardiovascular prognosis, influenced by arterial stiffness. Tonometric pulse wave velocity (PWV) and Augmentation index (AI) have been confirmed as a non-invasive method for arterial stiffness evaluation. The purpose of this study was to assess the relationship between nocturnal blood pressure dipping and arterial stiffness in the hypertensive subjects.
Methods
This was a retrospective study of patients underwent ambulatory blood pressure monitoring (ABPM) between April 2021 and April 2022 at our institution. 41 subjects with essential hypertension were included, mean age 55.6 (42% female, 58% male). BP measured by ambulatory monitoring every 20 min between 07:00 am and 23:00 pm and every 30 min at night, throughout 48 hours with a Mobil-o-graph device. Carotid-femoral PWV and AI also measured as an index of aortic stiffness, by using the Mobil-o-graph which uses a validated transfer function. Dipping was defined as a 10-20% fall in nocturnal BP; extreme dipping as greater than 20%, nondipping as less than 10%, and reverse-dipping as 0% at most fall in nocturnal BP.
Results
The relationship between PWV and percent of fall in nocturnal SBP (percent of dipping) had negatively related with univariate generalized linear model (coefficient = -0.148, p-value = 0.007). Following multivariate adjustment for age, gender, mean arterial pressure and AI, percent of dipping becomes a variable without significant effect to model (coefficient = -0.408, p-value = 0.110). Age and percent of dipping has significant negative relationship (coefficient = -0.145, p-value = 0.0247) and age is strongly positively related with PWV (coefficient = 0.134, p-value = 0.000001). When multivariate adjustment is made for gender, mean arterial pressure and AI, percent of dipping remains significant variable to model (coefficient = -0.126, p-value = 0.009)
Conclusion
Percent of fall in nocturnal SBP has significant negative correlation with PWV. When adjusted with age, percent of fall in nocturnal SBP becomes insignificant variable. This is because age is a confounding variable to multivariate model. Elderly patients have less percent of fall in nocturnal SBP which leads to higher PWV.