Non-Dipping Phenomenon; is it Reversible in Diabetic Hypertensive Cases?

Abstract

Objectives: To detect reversibility of non-dipping phenomenon in diabetic hypertensive patients. Materials and methods: This study enrolled 60 patients who were diabetic with uncontrolled hypertension with non-dipper pattern proved from the first ABPM. Then after office BP control, we classified the cases according to the second ABPM data regarding reversibility of non-dipping status into two groups: Group (I): Irreversible cases: included 56 patients, still having non-dipping pattern. Group (II): Reversible cases: only four cases who returned back into dipper status. Results: Mean age was 54.36 ± 5.62 years; and 73% of the study population was male. Also, 70 of the patients had LVH. There was no significant difference between both groups concerning demographic data p value was more than 0.05. Concerning ABPM data after BP control there was a highly significant difference between both groups regarding: Dipping % of SBP, Dipping % of DBP and Nocturnal SBP (p value<0.001). In addition, there was a significant difference between the two groups regarding: SBP in 24 h, Nocturnal DBP (p value<0.05). Also, there was highly significant difference between both groups regarding nighttime doses of antihypertensive medications (p value<0.001). Conclusion: Non-dipping phenomenon in diabetic hypertensive patients can be reversible. As such identifying non-dippers can be accomplished by conventional 24 h ABPM.