Relation between abnormalities in circadian blood pressure rhythm and target organ damage in normotensives.
BACKGROUND
To determine the individual effect of abnormalities in blood pressure (BP) circadian rhythm (non-dipping status (NDS), increased morning BP (MBP) or increased MBP surge (MBPS)) on target organ damage (TOD) and which of these is more closely related to TOD in normotensives.


RESULTS
The 24-h ambulatory BP monitoring (ABPM) and echocardiography were performed and urinary albumin excretion (UAE) was measured in 47 dipper (28 women, mean age 45.8 +/- 9.3) and 32 non-dipper (25 women, mean age 49.1 +/- 8.3 years) normotensive subjects. The left ventricular mass index (LVMI) was higher in non-dipper group (103.8 +/- 24.1 vs 91.6 +/- 23.5 g/m2, P=0.03). UAE in non-dipper group was higher, but the difference between the two was not statistically significant (18.9 [10.3, 28.9] vs 14.1 [7.5, 23.8], P=0.11). In multivariate analysis, both LVMI and UAE were affected by NDS and MBP independent of other confounding variables (for LVMI; Coefficient =0.27, P=0.01 and Coefficient =0.37, P=0.001, respectively, and for UAE; Coefficient =0.27, P=0.02 and Coefficient =0.28, P=0.01, respectively).


CONCLUSIONS
It may be postulated that increased night and MBP are the factors that cause TOD, and it seems reasonable to attempt to restore normal diurnal rhythm of the BP even in normotensive subjects.
Soylu
Ahmet
A
Department of Cardiology, Meram Medical School of Selcuk University, Konya, Turkey. asoylu44@gmail.com
Yazici
Mehmet
M
Duzenli
Mehmet Akif
MA
Tokac
Mehmet
M
Ozdemir
Kurtuluş
K
Gok
Hasan
H
D000328:Adult; D000419:Albuminuria / Q000209:etiology / Q000503:physiopathology; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D002940:Circadian Rhythm; D004452:Echocardiography; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000503:physiopathology / Q000652:urine; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment