title: Effects of Carotid Stenting on Nocturnal Nondipping Phenomenon.
abstract: BACKGROUND
  It is well known that nondipper blood pressure (BP) pattern is associated with an increased cardiovascular risk in hypertensive patients. The aim of this study is to observe whether carotid artery stent (CAS) procedure returns nondipper BP pattern to dipper pattern in hypertensive patients.
  
  
  METHODS
  Ambulatory BP monitorization (ABPM) was performed in 152 hypertensive patients who underwent CAS procedure 1 day before, and 1 day and 1 year after the procedure. BP monitorization of patients was classified as dipper and nondipper. BP parameters 1 year after CAS procedure were compared with preprocedure parameters.
  
  
  RESULTS
  According to baseline ambulatory BP follow-ups, a total of 152 hypertensive patients with 122 (80%) nondippers and 30 (20%) dippers were enrolled in this study. According to ABPM results 1 year after CAS procedure, 78 patients (64%) who had nondipper pattern at first transformed into dipper pattern and 44 patients (36%) remained to be nondippers. Moreover, 1 year after CAS procedure, 18 patients (60%) who had dipper pattern at first transformed into nondipper pattern and 12 patients (40%) remained as dippers. When BP follow-up values at 1 year after CAS procedure were compared with BP readings before the procedure, 78 patients (51%) who were nondipper before the procedure transformed into dipper pattern (P ≤ .01), whereas 44 patients (29%) with nondipper pattern remained to be nondippers (P = .01). Twelve patients (7.9%) who had dipper pattern remained to have dipper pattern (P = .768). Eighteen patients who had dipper pattern (12%) transformed into nondipper pattern after the procedure (P < .01). The total number of nondipper pattern patients before CAS procedure was 80.3% (122 patients), whereas this percentage dropped to 40.8% (62 patients) after the CAS procedure (P < .01).
  
  
  CONCLUSIONS
  During 1-year follow-up after CAS procedure, nondipper BP pattern transforms into dipper pattern. This result might be attributed to the contributory effect of CAS procedure to long-term cardiovascular protection.
authors.affiliation: Clinic of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey. Electronic address: drerkankoklu@gmail.com.
authors.forename: Erkan
authors.initials: E
authors.lastname: Köklü
authors.affiliation: Clinic of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: İsa Öner
authors.initials: İÖ
authors.lastname: Yüksel
authors.affiliation: Clinic of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Şakir
authors.initials: Ş
authors.lastname: Arslan
authors.affiliation: Clinic of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Nermin
authors.initials: N
authors.lastname: Bayar
authors.affiliation: Clinic of Family Physicians, İsmet Yüce Family Health Center, Antalya, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Köklü
authors.affiliation: Clinic of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Zehra
authors.initials: Z
authors.lastname: Erkal
authors.affiliation: Clinic of Cardiology, Türkiye Yüksek İhtisas Education and Research Hospital, Ankara, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Çay
authors.affiliation: Clinic of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Küçükseymen
authors.affiliation: Clinic of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Görkem
authors.initials: G
authors.lastname: Kuş
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D015607:Stents; D059289:Vascular Stiffness
keywords: Ambulatory blood pressure monitoring; carotid artery stenting; carotid sinus baroreceptor; dipper; nondipper; stroke