Effect of Antihypertensive Drugs on Circadian Variation of Blood Pressure Measured by Ambulatory Blood Pressure Monitoring in Controlled Hypertensive Individuals

Abstract

Background: Rewinding back a 100 years ago, Riva Rocci introduced the meticulous way of measuring blood pressure (BP) in clinical practice. With recent years, ambulatory BP monitoring came into existence which is still not used routinely in the management of hypertension. This thought led to the commencement of our study to analyze the variations in ambulatory BP recording over a 24-h cycle. Objectives: The objectives of the study are to determine the BP differences throughout the circadian cycle and to analyze the variations in circadian rhythm due to various antihypertensive drugs. Methods: On the first visit to the Medicine Outpatient Department, patient's medical history was recorded. Three readings of office BP were recorded using a sphygmomanometer. The patient was then provided with the ambulatory BP monitoring device, sent home and asked to follow-up after 24 h and the report was recorded. Results: On comparing the nocturnal pattern among candidates taking single versus combination drug, the dip was found to be in 31.7% in patients on single drug compared to 38.6% combination therapy. The surge in BP was seen in 56.8% of patients on single-drug therapy compared to 43.3% patients on combination drug therapy. Conclusion: Single-drug therapy for hypertension did not show a significant nocturnal pattern compared to the combination drug therapy for hypertension. The presence of the risk factors such as obesity smoking, dyslipidemia, diabetes mellitus, hypothyroidism, family history, and chronic kidney disease showed a presence of dipping and nondipping pattern in BP.