Abstract 2471: Non-Dipping Status Is Correlated with a State of Hypoadiponectinemia and Pronounced Arterial Stiffness in Essential Hypertensive Subjects
Introduction: The absence of nocturnal blood pressure (BP) fall is related through diverse mechanisms with adverse cardiovascular outcome, while adiponectin is emerging as a marker of atherosclerosis progression.
Hypothesis: Non-dipping status may be related to augmented levels of adiponectin and arterial stiffness in essential hypertensive subjects.
Methods: 148 newly diagnosed untreated non-diabetic patients with stage I to II essential hypertension [98 men, mean age=49 years, office BP=150/97 mmHg] underwent 24-h ambulatory BP monitoring and were classified as dippers and non-dippers according to the diurnal variation of >10% between mean daytime and nighttime systolic and diastolic BP. In all patients, arterial stiffness was evaluated on the basis of carotid to femoral pulse wave velocity (PWV), by means of a computerized method (Complior SP).
Results: Non-dippers (n=38) compared to dippers (n=110) were older (55±7 vs 49±9 years, p<0.0001), and had higher left ventricular mass index (119±12 vs 101±18 g/m2, p<0.05). In the total population, plasma adiponectin levels were negatively related with BMI (r=−0.168, p<0.05), office systolic BP (r=−0.285, p<0.0001), 24-h systolic BP (r=−0.194, p<0.05), total cholesterol (r=−0.220, p<0.005), and PWV (r=−0.280, p<0.001), while it was positively associated with systolic BP fall (r=0.520, p<0.001). Additionally, PWV was associated with BMI (r=0.233, p<0.05), 24-h systolic BP (r=0.327, p<0.0001) and negatively related to systolic BP fall (r=−0.17, p<0.05). Non-dippers compared to dippers exhibited attenuated adiponectin values (7.9±3.6 vs 9.7±4.4 μg/ml, p<0.05), and higher PWV values (8.6±1.2 vs 7.7±4.2 m/sec, p<0.05), while did not differ regarding metabolic profile (p=NS). Analysis of covariance revealed that adiponectin and PWV values remained statistically different between groups after adjustment for confounders (p<0.05).
Conclusions: Non-dippers hypertensives are characterized by more pronounced activation of pro-atherogenic mechanisms, as reflected by low levels of adiponectin, and arterial stiffening. These findings may partially explain the increased cardiovascular risk associated with non-dipping status, in this setting.