Non-dipping pattern in ambulatory blood pressure monitoring is associated with metabolic abnormalities in a random sample of middle-aged subjects

Sep 5, 2009Hypertension research : official journal of the Japanese Society of Hypertension

Non-dipping nighttime blood pressure is linked to metabolic problems in middle-aged adults

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Abstract

Non-dipping in 24-h ambulatory blood pressure monitoring is associated with higher levels of metabolic abnormalities in middle-aged subjects (n=462).

Subjects with a non-dipping pattern were more obese (P=0.014).
Non-dippers exhibited higher very-low-density lipoprotein (VLDL)-cholesterol (P=0.003) and triglycerides (P=0.026) compared to dippers.
Impaired glucose tolerance and metabolic syndrome were more prevalent among non-dippers (P<0.01).
ABPM non-dipping status independently predicted impaired glucose tolerance in multivariate analyses (P<0.05).
The percentage decline in blood pressure from day to night decreased with an increasing number of metabolic abnormalities (P=0.012).

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A reduction in the blood pressure decline at night (<10% from daytime systolic blood pressure (SBP)) during 24-h ambulatory blood pressure monitoring (ABPM) ('non-dipping pattern') is associated with cardiovascular morbidity. Our aim was to evaluate whether ABPM characteristics are associated with metabolic abnormalities in subjects without known hypertension or type 2 diabetes mellitus (T2DM). This is a cross-sectional population-based study on middle-aged subjects (n=462). Two distinct definitions of metabolic syndrome (MetS) were used: National Cholesterol Education Program-Third Adult Treatment Panel (NCEP-ATPIII) and International Diabetes Federation (IDF) criteria. Results suggested that subjects characterized by non-dipping in 24 h ABPM were more obese (P=0.014). After adjustment for body mass index, age and sex, non-dippers had higher very-low-density lipoprotein (VLDL)-cholesterol (P=0.003), total (P=0.029)-and VLDL-triglycerides (P=0.026) and oral glucose tolerance test 2 h blood glucose (P=0.027) compared with dippers. Non-dipping status was more common among subjects with MetS (P< or =0.01), impaired glucose tolerance (IGT) (P<0.05) and in those with the combination of IGT-T2DM (P< or =0.01) than among those without these abnormalities. ABPM non-dipping status was an independent predictor of IGT in multivariate models (P<0.05). With respect to MetS components, high triglycerides (P< or =0.005) and low high density lipoprotein-cholesterol (P<0.05) were associated with a non-dipping pattern. The percentage decline in blood pressure from day to night decreased with the number of metabolic abnormalities (P=0.012). In conclusion, ABPM non-dipping status is an independent predictor of glucose intolerance. It is also associated with several other metabolic abnormalities. Whether non-dipping pattern is causally related to these metabolic aberrations remains to be explored in a future prospective follow-up of this cohort.

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Non-dipping pattern in ambulatory blood pressure monitoring is associated with metabolic abnormalities in a random sample of middle-aged subjects

Abstract

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