PP.LB02.03

Abstract

Objective: Circadian pattern of BP is characterized by a nocturnal decrease of BP of 10–20% compared with diurnal BP (dipper). Subjects with nocturnal hypertension (>120/70) are at risk of systemic organ damage. Transversal clinical study of incident patients in our cardiovascular risk consultation office. To describe distribution of HBP classical pattern (dipper vs. non-dipper/riser) and nocturnal HBP(NHBP) with ABPM and to analyze clinical parameters associated with those patterns. Design and method: We collected data from all patients recently diagnosed with HBP, they were distributed according to classical pattern and also to NHBP. We gathered demographic characteristics of our population/albuminuria/BMI/DM/medication to treat HBP. Results: 96 patients (63% male, age 52.36 years SD:14.8); daily SBP 135.7 mmHg (SD:12.8), daily DBP 82 mmHg (SD:9.1); nocturnal SBP 126.0 mmHg (SD:16.12), nocturnal DBP nocturnal 72.4 mmHg (SD:9.9). 31% of dipper patients presented NHBP, which is considered a CV risk factor, however NHBP was undetected by the classical pattern classification. There were 27% classified as non dipper that did not have NHBP. According to the classical pattern: the presence of albuminuria (ACC > 30 mg/g) is associated with nondipper/riser pattern:(45.7% nondipper/riser vs. 20% dipper, p < 0.05).No differences were found in both groups in terms of BMI nor ongoing treatment with ACE inhibitors and ARBs. According to NHBP pattern yes/no: the presence NHBP is associated with higher prevalence of albuminuria(46%) compared with the absence of NHBP (16,1%;p < 0.05). Moreover patients with NHBP have a higher BMI than patients that do not have NHBP (75%vs.55.3%;p < 0.05). BMI was not a confounding factor, which is proven by the fact that 100% of patients with BMI < 25 presented albuminuria(p < 0.05). Regarding patients with BMI < 25,100% of the patients with NHBP presented albuminuria and only 28.6% of patients with non-dipper/riser pattern presented albuminuria. Conclusions: Stratification according to the presence of NHBP shows more association with albuminuria than the classical pattern does, which is more patent in patients with BMI < 25. Classification of patients using both methods can be discordant. Due to this, we should take into account the presence of NHBP as a cardiovascular risk factor whenever interpreting ABPM.