[PP.07.27] ASSOCIATION OF NOCTURNAL HYPERTENSION AND NON-DIPPING PATTERN WITH CAROTID ARTERY INTIMA-MEDIA THICKNES IN CHRONIC KIDNEY DISEASE PATIENTS. (September 2017)

• Record Type: Journal Article
• Authors: Manousopoulos, K.; Lykka, A.; Michas, F.; Kostogianni, K.; Dimitriou, A.; Zakopoulos, N.; Manios, E.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523382.50980.81
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Recent studies have demonstrated that nocturnal hypertension is better associated with target organ damage development and cardiovascular morbidity and mortality than non-dipping pattern in hypertensive patients. However, the role of nocturnal hypertension and non-dipping pattern, in terms of target organ damage involvement, in chronic kidney disease (CKD) patients is unclear. Aim of our study was to evaluate the impact of nocturnal hypertension and non-dipping pattern on common carotid artery intima-media thickness (CCA-IMT) in CKD patients. Design and method: A total 69 CKD patients, referred for evaluation at the Hypertension Unit of our department, underwent 24-h ambulatory blood pressure (BP) monitoring and CCA-IMT ultrasonographic measurements. The degree of nocturnal BP (BP) dipping (%) was calculated as 100[1 – nighttime SBP/daytime SBP]. Dippers were defined as subjects with nocturnal BP fall >10% and non-dippers as patients with nocturnal BP fall <10%. Nocturnal hypertension was defined as nighttime SBP >= 120 mmHg or DBP >= 70 mmHg. Statistical analysis was performed by means of independent-samples T test and ANCOVA. Results: The percentages of nocturnal hypertensives, systolic non-dippers and diastolic non-dippers were 68%, 65% and 50%, respectively. Systolic (r = −0.289, p = 0.019) and diastolic dipping (r = −0.352, p = 0.004), as continuous variables, significantly correlated with CCA-IMT. However, CCA-IMT did not differ significantly between systolic non-dippers (1.025 mm) and dippers (0.949 mm). In contrast, diastolic non-dippers (1.067 mm, p = 0.011) and nocturnal hypertensives (1.045 mm, p = 0.010) presented significantly higher CCA-IMT values than diastolic dippers (0.929 mm) and subjects with nocturnal normotension (0.898 mm), respectively, even after adjustment for demographic characteristics and baseline risk factors. Conclusions: Nocturnal hypertension and diastolic non-dipping pattern are associated with increased CCA-IMT values in CKD patients.