title: The relationship between dipper/nondipper pattern and cardioankle vascular index in hypertensive diabetic patients.
abstract: OBJECTIVE
  24-h ambulatory blood pressure monitoring (24-h ABPM) is a better predictor of cardiovascular events (CVEs) than spot blood pressure (BP) measurements in hypertensive diabetic patients. In this patient group, the underlying mechanism of the relationship between a nondipper pattern determined with 24-h ABPM and increased incidence of CVE is unknown. Cardioankle vascular index (CAVI) is a new index of the overall arterial stiffness from the aorta to the ankle. The objective of the present study was to evaluate the relationship between a dipper/nondipper pattern and arterial stiffness in hypertensive diabetic patients using the CAVI method.
  
  
  METHODS
  We enrolled 99 hypertensive patients with type-2 diabetes mellitus. 24-h ABPM and CAVI measurements were performed for all patients. The relationship between a dipper/nondipper pattern and CAVI measurements was analyzed.
  
  
  RESULTS
  Sixty-three (63.6%) patients had a nondipper pattern. In univariate analysis, CAVI, mean arterial pressure (MAP)-asleep, overall diastolic BP, overall systolic BP, duration of hypertension, and statin use were significantly higher among patients with a nondipper pattern than that in dippers. Multivariate linear regression analyses showed that the difference between MAP-asleep and MAP-awake was associated independently with CAVI (β coefficient=0.514, P<0.001). CAVI was correlated negatively with the nocturnal decrease in MAP (%) (r=-0.558 and P<0.001).
  
  
  CONCLUSIONS
  The nondipper pattern determined with 24-h ABPM in hypertensive diabetic patients is associated with an increase in arterial stiffness. This patient group should be monitored closely for CVEs.
authors.affiliation: Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey. ezgikalay@gmail.com
authors.forename: Ezgi
authors.initials: E
authors.lastname: Kalaycioğlu
authors.forename: Tayyar
authors.initials: T
authors.lastname: Gökdeniz
authors.forename: Ahmet Ç
authors.initials: AÇ
authors.lastname: Aykan
authors.forename: Ilker
authors.initials: I
authors.lastname: Gül
authors.forename: Ihsan
authors.initials: I
authors.lastname: Dursun
authors.forename: Gülhanim
authors.initials: G
authors.lastname: Kiriş
authors.forename: Sükrü
authors.initials: S
authors.lastname: Çelik
mesh_terms: D000368:Aged; D001158:Arteries / Q000473:pathology; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D059289:Vascular Stiffness