Abstract 2473: Dipping Status Definition Does not Differentiate the Estimated Magnitude of Subclinical Inflammation in non Dipper Hypertensives
Objective: Different dipping definitions in literature constitute a source of confusion regarding the significance of circadian blood pressure (BP) variation. We aimed to investigate the impact of three different dipping definitions on the assessed relation between inflammation and disrupted circadian blood pressure rhythm.
Methods: We studied 269 consecutive untreated subjects with stage I–II essential hypertension who underwent ambulatory blood pressure (BP) monitoring, echocardiographic examination and hs-CRP levels determination. According to their ambulatory BP data three different classifications into dippers and non-dippers were used, as presented in Table 1⇓.
Results: Non- dippers compared to dippers in all classifications had higher log hs- CRP values by 0.11, p=0.02; 0.13, p=0.03 and 0.14 mg/l, p=0.02 and 24h Pulse Pressure (PP) by 3.4 (p=0.006), 5.07 (p=0.003) and 5.4 mmHg (p<0.0001) respectively. Only in SND definition non-dippers had higher by 4.7 mmHg (p=0.003) 24h SBP. Multiple regression analysis identified body mass index (BMI), 24h Pulse Pressure (PP), nocturnal SBP fall and triglyceride levels as independent predictors of log hs-CRP in (p<0.05 in all cases).
Conclusions: Irrespectively of the definition, non- dippers compared to dippers are characterized by more intense inflammatory processes which along with the increased ambulatory PP classify them in a higher cardiovascular risk class.