Non-dipping nocturnal blood pressure in psoriasis vulgaris

Abstract

Psoriasis vulgaris is one of the most prevalent chronic, inflammatory skin disorders. Patients with psoriasis carry an excess risk of hypertension and adverse cardiovascular (CV) events. Blood pressure (BP) has a circadian rhythm characterised with lower values at night. A blunted nocturnal BP decline defined as non-dipping accelerates the development of hypertension and CV diseases. The aim of this study is to evaluate circadian variation of blood pressure in normotensive middle-aged patients with psoriasis vulgaris. Seventy adult patients with psoriasis vulgaris (group 1) and 70 age and sex-matched healthy individuals (group 2) were included in the study. Ambulatory BP monitoring was performed in all participants over a 24-h period. Non-dippers are defined as those who show a reduction in BP of less than 10% between the average day and night systolic BP. Although mean 24-h BPs were similar in both groups, night-time BPs were significantly higher in psoriatic patients (115.1 ± 7.7 vs. 109.9 ± 6.0mmHg and 72.1 ± 7.0 vs. 67.6 ± 5.5mmHg, respectively; p < 0.05). The non-dipping pattern of BP changes was significantly more common in patients with psoriasis vulgaris compared with the control group (65.9 vs. 34.1%, p < 0.01). Psoriasis severity and BMI are independent predictors of impaired nocturnal BP regulation. Patients with psoriasis vulgaris had increased nocturnal BP and heart rate. This is the first study to demonstrate a blunted nocturnal BP decrease in normotensive patients with psoriasis.