title: Non-dipping pattern in ambulatory blood pressure monitoring is associated with metabolic abnormalities in a random sample of middle-aged subjects.
abstract: A reduction in the blood pressure decline at night (<10% from daytime systolic blood pressure (SBP)) during 24-h ambulatory blood pressure monitoring (ABPM) ('non-dipping pattern') is associated with cardiovascular morbidity. Our aim was to evaluate whether ABPM characteristics are associated with metabolic abnormalities in subjects without known hypertension or type 2 diabetes mellitus (T2DM). This is a cross-sectional population-based study on middle-aged subjects (n=462). Two distinct definitions of metabolic syndrome (MetS) were used: National Cholesterol Education Program-Third Adult Treatment Panel (NCEP-ATPIII) and International Diabetes Federation (IDF) criteria. Results suggested that subjects characterized by non-dipping in 24 h ABPM were more obese (P=0.014). After adjustment for body mass index, age and sex, non-dippers had higher very-low-density lipoprotein (VLDL)-cholesterol (P=0.003), total (P=0.029)-and VLDL-triglycerides (P=0.026) and oral glucose tolerance test 2 h blood glucose (P=0.027) compared with dippers. Non-dipping status was more common among subjects with MetS (P< or =0.01), impaired glucose tolerance (IGT) (P<0.05) and in those with the combination of IGT-T2DM (P< or =0.01) than among those without these abnormalities. ABPM non-dipping status was an independent predictor of IGT in multivariate models (P<0.05). With respect to MetS components, high triglycerides (P< or =0.005) and low high density lipoprotein-cholesterol (P<0.05) were associated with a non-dipping pattern. The percentage decline in blood pressure from day to night decreased with the number of metabolic abnormalities (P=0.012). In conclusion, ABPM non-dipping status is an independent predictor of glucose intolerance. It is also associated with several other metabolic abnormalities. Whether non-dipping pattern is causally related to these metabolic aberrations remains to be explored in a future prospective follow-up of this cohort.
authors.affiliation: Institute of Clinical Medicine, Department of Internal Medicine and Biocenter Oulu, University of Oulu, and Clinical Research Center, Oulu University Hospital, Oulu, Finland. olavi.ukkola@oulu.fi
authors.forename: Olavi
authors.initials: O
authors.lastname: Ukkola
authors.forename: Riitta-Liisa
authors.initials: RL
authors.lastname: Vasunta
authors.forename: Y Antero
authors.initials: YA
authors.lastname: Kesäniemi
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm / Q000502:physiology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D005260:Female; D018149:Glucose Intolerance / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D008079:Lipoproteins, VLDL / Q000097:blood; D016015:Logistic Models; D008297:Male; D008659:Metabolic Diseases / Q000503:physiopathology*; D024821:Metabolic Syndrome / Q000378:metabolism; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008079:Lipoproteins, VLDL; D014280:Triglycerides; C030106:very low density lipoprotein triglyceride