Higher Frequency of Nocturnal Blood Pressure Dipping but Not Heart Rate Dipping in Inflammatory Bowel Disease.

Abstract

Masked hypertension (MHTN) and lack of nocturnal dipping in blood pressure (BP) have been linked to the state of inflammation. We aimed to assess the frequency of nocturnal patterns of BP and heart rate (HR) in patients with IBD. Sixty-three normotensive patients with confirmed IBD during remission and 63 healthy subjects were enrolled in a case-control study. All subjects were monitored for BP and HR over a period of 24h under ambulatory setting. Means for BP and HR were calculated for nighttime and daytime periods. Daytime BP≥135/85mmHg, nighttime BP≥120/70mmHg, and 24-h average BP≥130/80mmHg were defined as MHTN. The main end points of this study were lack of >10% nocturnal decrease in the systolic BP (NDP-BP) and in HR (NDP-HR). After exclusion of 8 patients with IBD from analysis, 55 patients and 63 control subjects (49% men) with a mean age of 37.5±11.0years were enrolled. NDP-BP was more common in the IBD group compared to controls (55 vs. 33%; P=0.026). MHTN was detected in 24% of IBD patients compared to 8% among controls (P=0.017). Meanwhile, NDP-HR was observed in 22% of the IBD patients and 30% of the control group (P=0.402). IBD remained a significant predictor of NDP-BP (odds ratio 2.60, 95% confidence interval 1.19-5.51) following an adjustment for age and gender. IBD is associated with higher frequency of NDP-BP and MHTN; however, nocturnal changes in HR were similar in both groups.