Abstract
Objective
Non-dipper blood pressure (NDBP) pattern is associated with end-organ damage and cardiovascular mortality. Predicting and managing the NDBP pattern can prevent cardiovascular adverse events.The study aims to investigate the relationship between NDBP pattern and aortic valve sclerosis (AVS) detected during routine echocardiography in hypertensive patients.
Material and Methods
A total of 222 patients using at least one antihypertensive drug were included in the study. The patients were divided into two groups as dipper and NDBP pattern according to ambulatory blood pressure monitoring (ABPM). NDBP pattern was defined as reducing night systolic BP by <10% compared to daytime systolic BP. Patients outside this definition were defined as dipper hypertensives. AVS was defined as the thickening or calcification in the semilunar cusps, without stenosis in transthoracic echocardiography.
Results
The average age of patients with the NDBP pattern was 68.21±6.22, while it was 66.80±5.38 for patients with dipper BP pattern (p=0.075). As a result of ABPM, dipper BP (45%) was detected in 100 patients, and NDBP (55%) was detected in 122 patients. AVS was detected in 39 patients (17.6%), and the majority of them were in the NDBP group (3.6% vs. 14%, p<0.001). As a result of multivariate regression analysis, the only independent predictor of the NDBP pattern was AVS (odds ratio =3,078, 95% confidence interval 1.280-7.403, p=0.012)
Conclusion
In hypertensive patients, AVS detected by transthoracic echocardiography is associated with NDBP. The presence of AVS may be an essential factor in the detection of the NDBP pattern, that is closely related to major cardiovascular events.
Keywords: Non-dipper blood pressure, aortic valve sclerosis, ambulatory blood pressure monitoring
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