ARTERIAL-DISEASE IN DIPPER AND NONDIPPER HYPERTENSIVE PATIENTS

Carotid artery and small vessel structural changes were evaluated in 4 5 dipper and 45 nondipper hypertensive subjects matched for sex, age, body mass index, smoking habit, and serum lipids. Patients underwent c arotid ultrasonography to evaluate lumen diameter, intima-media thickn ess, cross-sectional area, and atherosclerotic plaques, and plethysmog raphic examination to record minimum forearm vascular resistance. In t he whole study population, carotid cross-sectional area and prevalence of atherosclerotic plaques tended to be higher in nondippers than in dippers (19.9 +/- 6.0 v 17.5 +/- 6.1 mm(2), P = .07, and 40% v 26%, P = .18), whereas intima-media thickness and minimum forearm vascular re sistance were significantly higher in nondippers than in dippers (0.89 +/- 0.12 v 0.8 +/- 0.15 mm, P < .02, and 2.53 +/- 0.3 v 2.34 +/- 0.3 arbitrary resistance units (RU), P < .02). When gender was taken into account, different results were obtained in men and women. In men, vas cular characteristics were not significantly different between dippers and nondippers. In women, carotid cross-sectional area and prevalence of atherosclerotic plaques tended to be higher in nondippers than in dippers (18.3 +/- 4.9 v 15.5 +/- 4.5 mm(2), P = .06, and 40% v 15%, P = .15), and intima-media thickness and minimum forearm vascular resist ance were significantly higher in nondippers than in dippers both befo re (0.84 +/- 0.1 v 0.73 +/- 0.1 mm, P < .01, and 2.38 +/- 0.3 v 2.16 /- 0.2 RU, P < .01) and after adjustment for 24-h blood pressure. In c onclusion, our data suggest that the progression of vascular disease m ay be differently affected in the two sexes by a different circadian b lood pressure profile. (C) 1997 American Journal of Hypertension, Ltd.