Abstract 15224: Non-dipping Pattern is Associated with Hypoadiponectinemia and Increased Arterial Stiffness in Essential Hypertensive Subjects
Introduction: The absence of nocturnal blood pressure (BP) fall is related to adverse cardiovascular outcome, while adiponectin is emerging as a marker of atherosclerosis progression.
Hypothesis: Non-dipping status may be associated with plasma concentrations 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. Arterial stiffness was evaluated on the basis of carotid to femoral pulse wave velocity (PWV), using Complior SP. Lipid profile and adiponectin levels were assessed from venous blood samples.
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), waist to hip ratio, (r=−0.421, p<0.0001), 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 the two groups 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 confounding factors (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, thus indicating the increased cardiovascular risk associated with non-dipping status.
- © 2010 by American Heart Association, Inc.