title: Cluster analysis: a new approach for identification of underlying risk factors for coronary artery disease in essential hypertensive patients.
abstract: Grading of essential hypertension according to blood pressure (BP) level may not adequately reflect clinical heterogeneity of hypertensive patients. This study was carried out to explore clinical phenotypes in essential hypertensive patients using cluster analysis. This study recruited 513 hypertensive patients and evaluated BP variations with ambulatory blood pressure monitoring. Four distinct hypertension groups were identified using cluster analysis: (1) younger male smokers with relatively high BP had the most severe carotid plaque thickness but no coronary artery disease (CAD); (2) older women with relatively low diastolic BP had more diabetes; (3) non-smokers with a low systolic BP level had neither diabetes nor CAD; (4) hypertensive patients with BP reverse dipping were most likely to have CAD but had least severe carotid plaque thickness. In binary logistic analysis, reverse dipping was significantly associated with prevalence of CAD. Cluster analysis was shown to be a feasible approach for investigating the heterogeneity of essential hypertension in clinical studies. BP reverse dipping might be valuable for prediction of CAD in hypertensive patients when compared with carotid plaque thickness. However, large-scale prospective trials with more information of plaque morphology are necessary to further compare the predicative power between BP dipping pattern and carotid plaque.
authors.affiliation: Department of Cardiology, the Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Guo
authors.affiliation: Shaanxi Engineering Research Center of Medical and Health BIGDATA, School of Management, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Xiaoni
authors.initials: X
authors.lastname: Lu
authors.affiliation: Department of Emergency Medicine, the Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Ya
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Emergency Medicine, the Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Emergency Medicine, the Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Yan
authors.affiliation: Department of Cardiology, the Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Su
authors.affiliation: Department of Cardiology, the Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Anqi
authors.initials: A
authors.lastname: Song
authors.affiliation: Shaanxi Engineering Research Center of Medical and Health BIGDATA, School of Management, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Emergency Medicine, the Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
mesh_terms: D000368:Aged; D001794:Blood Pressure; D059168:Carotid Intima-Media Thickness; D002940:Circadian Rhythm; D016000:Cluster Analysis; D003324:Coronary Artery Disease / Q000453:epidemiology*; D000075222:Essential Hypertension / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors