title: Relationships of different blood pressure categories to indices of inflammation and platelet activity in sustained hypertensive patients with uncontrolled office blood pressure.
abstract: Failure to decrease blood pressure (BP) normally during nighttime (non-dipping) in hypertension is associated with higher cardiovascular morbidity and mortality. In addition, non-dipping BP is associated with increased platelet activity and inflammatory response; however, there has been no study to evaluate the relationship of non-dipping BP to indices of platelet activity and inflammation in uncontrolled hypertensive patients. In the present study, hypertensive subjects with uncontrolled office BP were firstly divided into three groups: 84 subjects with white coat effect and 365 subjects with true uncontrolled hypertension. Then, true uncontrolled hypertensive patients were divided into two groups: 158 patients with dipping and 207 patients with non-dipping. Mean platelet volume (MPV), uric acid (UA), γ-glutamyltransferase (GGT), C-reactive protein (CRP), and high-sensitivity CRP (hs-CRP) levels were studied. The general characteristics and risk factors for coronary artery disease (CAD) of the study population were similar among the groups. MPV, UA, GGT, CRP, and hs-CRP levels were significantly higher in non-dipper group than both dipper and white coat effect groups, and were significantly higher in dipper group than in white coat effect group (MPV: 9.1 ± 1.3, 8.7 ± 1.1, and 8. ± 0.9 fL; UA: 6.9 ± 1.2, 5.9 ± 1.4, and 4.1 ± 0.8 mg/dL; GGT: 38.9 ± 11.1, 33.6 ± 14.9, and 25.2 ± 9.2 U/L; CRP: 7.1 ± 2.4, 6.2 ± 1.9, and 3.9 ± 0.8 mg/dL; hs-CRP: 3.8 ± 1.5, 3.3 ± 1.2, and 2.0 ± 0.6, non-dipper, dipper, and white coat effect groups, respectively, all p values <0.01). All study parameters strongly correlated with each other. In conclusion, in hypertensive patients with uncontrolled office BP, presence of non-dipping BP is associated with increased platelet activity and inflammation, which can be one of the underlying plausible mechanisms of non-dipping BP status.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey. aydoganer@yahoo.com
authors.forename: Dogan
authors.initials: D
authors.lastname: Erdogan
authors.forename: Atilla
authors.initials: A
authors.lastname: Icli
authors.forename: Fatih
authors.initials: F
authors.lastname: Aksoy
authors.forename: Salaheddin
authors.initials: S
authors.lastname: Akcay
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozaydin
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ersoy
authors.forename: Ercan
authors.initials: E
authors.lastname: Varol
authors.forename: Abdullah
authors.initials: A
authors.lastname: Dogan
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination; D002097:C-Reactive Protein / Q000032:analysis; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D063847:Mean Platelet Volume; D008875:Middle Aged; D015999:Multivariate Analysis; D009819:Office Visits; D015539:Platelet Activation; D011237:Predictive Value of Tests; D014527:Uric Acid / Q000097:blood; D059466:White Coat Hypertension / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D018836:Inflammation Mediators; D014527:Uric Acid; D002097:C-Reactive Protein; D005723:gamma-Glutamyltransferase