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Nondipping Pattern and Carotid Atherosclerosis in a Middle-Aged Population: OPERA Study

Identifieur interne : 000908 ( Main/Exploration ); précédent : 000907; suivant : 000909

Nondipping Pattern and Carotid Atherosclerosis in a Middle-Aged Population: OPERA Study

Auteurs : Riitta-Liisa Vasunta [Finlande] ; Y. Antero Kes Niemi [Finlande] ; Antti Ylitalo [Finlande] ; Olavi Ukkola [Finlande]

Source :

RBID : Pascal:12-0150597

Descripteurs français

English descriptors

Abstract

BACKGROUND The lack of dropping in night-time blood pressure of 10% or more (nondipping) seems to associate with cardiovascular risk factors. The relationship between the dipping pattern and atherosclerosis is not clear. The night-time systolic blood pressure (SBP) determines the dipping status. METHODS We investigated the connection between intima-media thickness (IMT) and dipping status (dipper, nondipper) taking into account covariates known to associate with hypertension and early atherosclerosis. 900 middle-aged (446 men, 454 women) were studied, 51 % of them using blood pressure lowering medication. IMTwas measured by a duplex ultrasound from the common carotid artery (CCA), the internal carotid artery (ICA) and the bifurcation enlargement (BIF).The mean IMT was defined as the mean of ICA, BIF, and the 3 highest CCA measurements. Ambulatory blood pressure (ABP) was recorded using the fully automatic SpaceLabs90207 oscillometric unit. RESULTS Nondippers had lower high-density lipoprotein cholesterol (P= 0.02), higher triglycerides (P<0.01), body mass index (P<0.0001) and higher night-time blood pressure (P < 0.0001) than dippers and they were more often nonsmokers (P=0.01). Increased mean IMT in carotid artery was associated with ABP nondipping pattern (P < 0.01) regardless of conventional cardiovascular risk factors, antihypertensive or lipid lowering medications. Nocturnal blood pressure elevation was independently associated with IMT (P < 0.01). When sexes were analysed separately, the association was seen in men but was only a trend among women. CONCLUSIONS Nondipping status in ABP monitoring is independently associated with early atherosclerosis. Whether nondipping pattern is a predictor of atherosclerosis remains to be explored in a future prospective follow-up of this cohort.


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<div type="abstract" xml:lang="en">BACKGROUND The lack of dropping in night-time blood pressure of 10% or more (nondipping) seems to associate with cardiovascular risk factors. The relationship between the dipping pattern and atherosclerosis is not clear. The night-time systolic blood pressure (SBP) determines the dipping status. METHODS We investigated the connection between intima-media thickness (IMT) and dipping status (dipper, nondipper) taking into account covariates known to associate with hypertension and early atherosclerosis. 900 middle-aged (446 men, 454 women) were studied, 51 % of them using blood pressure lowering medication. IMTwas measured by a duplex ultrasound from the common carotid artery (CCA), the internal carotid artery (ICA) and the bifurcation enlargement (BIF).The mean IMT was defined as the mean of ICA, BIF, and the 3 highest CCA measurements. Ambulatory blood pressure (ABP) was recorded using the fully automatic SpaceLabs90207 oscillometric unit. RESULTS Nondippers had lower high-density lipoprotein cholesterol (P= 0.02), higher triglycerides (P<0.01), body mass index (P<0.0001) and higher night-time blood pressure (P < 0.0001) than dippers and they were more often nonsmokers (P=0.01). Increased mean IMT in carotid artery was associated with ABP nondipping pattern (P < 0.01) regardless of conventional cardiovascular risk factors, antihypertensive or lipid lowering medications. Nocturnal blood pressure elevation was independently associated with IMT (P < 0.01). When sexes were analysed separately, the association was seen in men but was only a trend among women. CONCLUSIONS Nondipping status in ABP monitoring is independently associated with early atherosclerosis. Whether nondipping pattern is a predictor of atherosclerosis remains to be explored in a future prospective follow-up of this cohort.</div>
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