Nocturnal blood pressure and cardiovascular risk factors in hypertensive patients

BACKGROUND: Blood pressure (BP) has a circardian rhythm. Most of the people presents a BP fall between 10-20% during nighttime hours (dipper condition ). Measurement of these circadian variations is performed by continuous blo od pressure ambulatory monitoring. We have studied the possible relation be tween blood pressure nocturnal fall and cardiovascular risk factors in hype rtensive patients. METHODS: We selected 100 hypertensive patients from the Hypertension and Li pids Unit of San Cecilio University Hospital of Granada, Spain. They were d ivided into two groups: dippers group and non-dippers, depending of whether or not the fall of nocturnal systolic and diastolic BP was > 10%. All pati ents included in the study underwent complete clinical history, exhaustive physical examination, complementary examinations, urine and hematology test s, and continuous blood pressure ambulatory monitoring by the Space Labs sy stem. RESULTS: The heart rate was found to be significantly higher (p = 0.0253) i n the hypertensive dippers group than in the non-dippers. The latter showed higher plasma creatinine values (p = 0.0343) and lower potassemia values ( p = 0.0140) than the dippers group. The dippers group presented concentrati ons of HDL-cholesterol significantly higher (p = 0.008) and diurnal diastol ic BP values (p = 0.0211) also higher than the other group. CONCLUSIONS: Non dippers hypertensive patients present a higher number of c ardiovascular risk factors as well as a higher tendency to renal lesions, a nd worse prognosis than the dippers group.