title: Covariates of non-dipping and elevated night-time blood pressure in ischemic stroke patients: the Norwegian Stroke in the Young Study.
abstract: Abnormal night-time blood pressure (BP) reduction is associated with increased cardiovascular risk in hypertension. Little is known about the prevalence and covariates of night-time BP reduction in ischemic stroke patients. Clinic and ambulatory BP measurements were recorded in 268 stroke survivors aged 15-60 years. The degree of night-time dipping was calculated from the difference between day-time and night-time mean BP, and defined as non-dipping if < 10%. Aortic stiffness was derived from carotid-femoral pulse-wave velocity (PWV) by applanation tonometry and carotid intima-media thickness (cIMT) by ultrasound. A non-dipping pattern was found in 38%. Non-dippers had higher PWV, mean cIMT and night-time BP, and included more patients with history of hypertension, diabetes and high for age PWV compared to dippers (all p < 0.05). In multivariate logistic regression analyses, non-dipping was associated with high for age PWV [odds ratio (OR) = 2.28; 95% confidence interval (CI) 1.06-4.92, p < 0.05] independent of history of hypertension and other confounders, while elevated night-time BP was associated with increased cIMT (OR = 3.83; 95% CI 1.01-14.50, p < 0.05) independent of non-dipping status, male gender, obesity, antihypertensive treatment and high for age PWV. In conclusion, in the Norwegian Stroke in the Young Study, non-dipping BP pattern was common and associated with increased aortic stiffness.
authors.affiliation: a Department of Heart Disease , Haukeland University Hospital , Bergen , Norway ;|b Department of Clinical Science , University of Bergen , Bergen , Norway ;
authors.forename: Sahrai
authors.initials: S
authors.lastname: Saeed
authors.affiliation: c Department of Neurology , Haukeland University Hospital , Bergen , Norway ;
authors.forename: Ulrike
authors.initials: U
authors.lastname: Waje-Andreassen
authors.affiliation: b Department of Clinical Science , University of Bergen , Bergen , Norway ;
authors.forename: M T
authors.initials: MT
authors.lastname: Lønnebakken
authors.affiliation: c Department of Neurology , Haukeland University Hospital , Bergen , Norway ;
authors.forename: Annette
authors.initials: A
authors.lastname: Fromm
authors.affiliation: d Department of Clinical Medicine , University of Bergen , Bergen , Norway.
authors.forename: Halvor
authors.initials: H
authors.lastname: Øygarden
authors.affiliation: c Department of Neurology , Haukeland University Hospital , Bergen , Norway ;
authors.forename: Halvor
authors.initials: H
authors.lastname: Naess
authors.affiliation: b Department of Clinical Science , University of Bergen , Bergen , Norway ;
authors.forename: Eva
authors.initials: E
authors.lastname: Gerdts
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017440:Photoperiod; D063177:Pulse Wave Analysis; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D059289:Vascular Stiffness; D055815:Young Adult
keywords: Arterial stiffness; carotid intima–media thickness; hypertension; ischemic stroke; non-dipping; pulse-wave velocity