Abstract 13173: Nondipping Pulse Rate was Associated with a High Level of Brain Natriuretic Peptide in Treated Hypertensive Patients
Introduction: There have been several reports on the relationship between nondipper pulse rate (PR) pattern and cardiovascular events in hypertensive patients. However, it remains unclear whether there is a relationship between a nondipper PR and hypertensive target organ damage.
Hypothesis: We hypothesized nondipping PR in treated hypertensive patients is associated with target organ damage.
Methods: Ambulatory blood pressure (BP) monitoring (ABPM) was conducted in 1003 hypertensive patients enrolled in the Japan Morning Surge Home Blood Pressure Study. BP nondipper status was defined as (Awake SBP - Sleep SBP)/Awake SBP < 0.1. PR nondipper status was defined as (Awake PR - Sleep PR)/Awake PR< 0.1. We also measured the brain natriuretic peptide level (BNP) and urinary albumin-creatinine ratio (UACR).
Results: The subjects with a nondipper PR status (N=247) were older(67.8±10.4 vs. 64.9±11.4 years, p=0.001)and had a higher level of BNP (mean BNP: 26.7 vs. 18.9 pg/dL, p<0.001) than those with a dipping PR status (N=756). But there were no differences in UACR between the two groups (mean UACR: 12.9 vs. 13.2 mg/gCr, p=0.65). Patients were classified into four subgroups according to their BP- and PR-dipping status. BP dipper and PR nondipper patients (N=137, mean BNP 20.5 pg/dL, p=0.004), BP nondipper and PR dipper patients (N=344, mean BNP 24.3 pg/dL, p=0.001)and BP nondipper and PR nondipper patients (N=110, mean BNP 36.1 pg/dL, p<0.001) had a higher level of BNP than BP dipper and PR dipper patients (N=412, mean BNP 15.9 pg/dL) by Bonferroni’s analysis. PR nondipping status was associated with the BNP level after adjustment for age, gender, 24-h BP, 24-h PR, and BP dipping pattern(β=0.11, p<0.001).
Conclusions: PR nondipping was independently associated with a higher level of BNP, but was not associated with UACR in treated hypertensive patients. The association between PR nondipping status and cardiac damage might explain subsequent cardiovascular events.
Author Disclosures: Y. Oba: None. T. Kabutoya: None. S. Hoshide: None. K. Eguchi: None. K. Kario: None.
- © 2014 by American Heart Association, Inc.