Nocturnal Hypertension Correlates Better With Target Organ Damage in Patients With Chronic Kidney Disease than a Nondipping Pattern

J Clin Hypertens (Greenwich). 2015 Oct;17(10):792-801. doi: 10.1111/jch.12589. Epub 2015 Jun 4.

Abstract

Both nocturnal hypertension and nondipping pattern are associated with target organ damages (TODs); however, no data exist with respect to Chinese patients with chronic kidney disease (CKD). The authors recruited 1322 patients with CKD admitted to our hospital division and referred with data in this cross-sectional study. Patients with nocturnal systolic hypertension had a lower estimated glomerular filtration rate (eGFR) and higher left ventricular mass index (LVMI) and carotid intima-media thickness (cIMT) compared with patients with normal nocturnal systolic blood pressure (SPB; all, P<.001), while patients in the dipper and nondipper groups had similar levels of eGFR, LVMI, and cIMT when the patients had a similar nocturnal SBP. Factorial-designed analysis of variance indicated that the main effect of nocturnal SBP was significant for all TOD differences (all, P<.001), but no significance existed with respect to the main effect of the dipper pattern and an interaction between the two factors (all, P>.05). Nocturnal systolic hypertension, rather than nondipping pattern, was an independent risk factor for TOD in CKD patients. Nocturnal hypertension, rather than a nondipping pattern, was better associated with TOD in CKD patients.

MeSH terms

  • Adult
  • Blood Pressure / physiology
  • Blood Pressure Monitoring, Ambulatory
  • Carotid Arteries / diagnostic imaging
  • Carotid Intima-Media Thickness
  • China / epidemiology
  • Circadian Rhythm / physiology*
  • Cross-Sectional Studies
  • Female
  • Glomerular Filtration Rate / physiology
  • Humans
  • Hypertension / diagnostic imaging
  • Hypertension / epidemiology
  • Hypertension / physiopathology*
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Male
  • Middle Aged
  • Prevalence
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / physiopathology*
  • Risk Factors