Blunted nocturnal fall of blood pressure in isolated clinical hypertension.
OBJECTIVE
The aim of the study is to assess the relation between diurnal blood pressure variations and target organ damage in isolated clinical hypertension (ICH).


METHODS
Ninety patients with ICH (clinical systolic blood pressure [SBP] superior or equal to [>=] 140 and/or diastolic blood pressure [DBP]> = 90 mm Hg) and ambulatory daytime SBP and DBP <135/85 mm Hg were enrolled in this study. Patients with ICH were classified into two groups as dippers (13 males, 34 females) and nondippers (7 males, 36 females). Nondippers were defined by a reduction in mean blood pressure of less than 10% from day (06:00-24:00) to night (24:00-6:00); and the rest of the patients were classified as dippers. Left ventricular mass index (LVMI) and early diastolic velocity/late diastolic velocity (e/a) were determined by echocardiography; intima-media thickness (IMT) and compliance of the carotid artery (distensibility coefficient [DC] and compliance coefficient [CC]) were measured by ultrasound. Renal function was measured by glomerular filtrate rate (GFR) and urinary albumin excretion (UAE). Retinal changes were determined by fundoscopy.


RESULTS
There was no difference between the demographic and biochemical characteristics of the two groups. IMT was significantly higher in nondippers (p <0.005). The nondippers had significantly lower levels of DC (p <0.005) and CC (p <0.0005). LVMI was above normal in both groups with no significant difference. The e/a ratio, although normal in both groups, differed significantly between them (p <0.0005). HTRP, microalbuminuria and GFR <90 mL/min/1.73 m2 were more frequent in nondipper ICH patients.


CONCLUSIONS
The results of the study suggest that in ICH nondipping is associated with a decrease in arterial compliance. The global risk load for target organ.
Turfaner
N
N
Istanbul University, Cerrahpasa Medical Faculty, Department of Family Medicine, Istanbul, Turkey. nurver@istanbul.edu.tr
Karter
Y
Y
Curgunlu
A
A
Ayan
F
F
Mihmanli
I
I
Sipahioglu
F
F