Non-Dipper Hypertension, a Novel Parameter to Determine Progression of CAD

Cardiovascular parameters such as blood pressure, heart rate, coronary tone change with circadian rhythm throughout the day. This circadian rhythm in blood pressure led to the creation of a new classification. In this classification made with ambulatory blood pressure monitoring, 10% or more decrease in blood pressure value measured at night compared to daytime value is defined as dipper hypertension and less than 10% decrease in non-dipper hypertension. Patients with non-dipper hypertension have been shown to have higher target organ damage and have a higher rate of cardiovascular mortality and morbidity. However, its effect on coronary artery disease progression is unknown. Therefore, Denİz ElÇİk and colleagues conducted a study to investigate the effect of non-dipper hypertension on the progression of coronary atherosclerosis.

Researchers included 186 patients who underwent coronary angiography twice between six months and three years. Coronary angiography was repeated on the admission day due to angina or positive exercise test and the researchers divided the patients into two groups according to presence and absence of progression.

Key findings of the study were:

• They found 58 of 186 patients with the progression of coronary artery disease.

• They also found 71 patients with non-dipper hypertensive.

• They noted that non-dipper hypertension, hypertension, diabetes mellitus, low-density lipoprotein, and total cholesterol were found to be effective in the progression of CAD.

• Among these parameters, they reported that non-dipper hypertension and hyperlipidemia were the most important independent risk factors.

The authors concluded, "Coronary artery disease is a progressive disease, and this progression depends on many reasons. In our study, we showed that non-dipper hypertension is a new parameter that is effective in CAD progression".

For further information:

doi: 10.3906/sag-2011-225.