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Disturbed circadian blood pressure rhythm and C-reactive protein in essential hypertension

Journal of Human Hypertension volume 22, pages 501–508 (2008)Cite this article

Abstract

We investigated the effect of the diverse definition criteria of the dipping and non-dipping status on the assessed differences in inflammatory activation between dippers and non-dippers with essential hypertension. 269 consecutive subjects (188 males, aged 50±7 years) with untreated stage I–II essential hypertension underwent ambulatory blood pressure (BP) monitoring and high-sensitivity C-reactive protein (hs-CRP) level determination. The population was classified into dippers and non-dippers based on the three following different definitions: true non-dippers (TND): non-dippers (nocturnal fall of systolic and diastolic BP of <10% of the daytime values, n=95) and dippers (the remaining subjects, n=174); true dippers and true non-dippers (TD–TND): non-dippers (nocturnal fall of systolic and diastolic BP<10%, n=95) and dippers (nocturnal fall of systolic and diastolic BP⩾10%, n=75); systolic non-dippers (SND): non-dippers (nocturnal systolic BP fall of <10% of the daytime values, n=145) and dippers (the remaining subjects, n=124). Non-dippers compared to dippers in the TND, TD–TND and SND classification exhibited higher levels of log hs-CRP (by 0.11 mg l−1, P=0.02; 0.13 mg l−1, P=0.03 and 0.14 mg l−1, P=0.02, respectively) and 24 h pulse pressure (PP) (by 4 mm Hg, P=0.006; by 5 mm Hg, P=0.003 and by 5 mm Hg, P<0.0001, respectively). Twenty-four hour PP and nocturnal systolic BP fall were independent predictors of log hs-CRP (P<0.05 for both) in multiple regression analysis. In conclusion, essential hypertensive non-dippers compared to dippers exhibit higher hs-CRP values, irrespective of the dipping status definition. Furthermore, ambulatory PP and nocturnal systolic BP fall interrelate and participate in the inflammatory processes that accompany non-dipping state.

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Authors and Affiliations

  1. First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece

    C Tsioufis, K Dimitriadis, C Thomopoulos, D Tsiachris, M Selima & C Stefanadis

  2. Department of Cardiology, Hippokration Hospital, Athens, Greece

    D Syrseloudis, P Pavlidis & I Kallikazaros

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  1. C Tsioufis
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Correspondence to C Tsioufis.

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Tsioufis, C., Syrseloudis, D., Dimitriadis, K. et al. Disturbed circadian blood pressure rhythm and C-reactive protein in essential hypertension. J Hum Hypertens 22, 501–508 (2008). https://doi.org/10.1038/jhh.2008.20

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