ABSTRACT

Objective: The role of dipping blood pressure pattern in normotensives is unclear. The study aims to search the circadian blood pressure rhythm and the clinical determinants related to reverse dipping pattern in a strictly selected, normotensive population.

Methods: The study population was divided into three groups depending on the nocturnal dipping pattern as dipping, non-dipping, and reverse dipping. Basal clinical characteristics, anthropometric measurements, and spot urine samples from the first-morning void were collected. Clinical determinants related to the presence of reverse dipping pattern were tested by the Multiple Binary Logistic Regression analysis.

Results: A total of 233 participants were involved in the study population (median age 45 years [40–50]). Dipping pattern was detected in 55.4%, non-dipping pattern in 33.0%, and reverse dipping pattern in 11.6% of the study population. There was no difference between the groups in terms of basal clinical features. Albumin-to-creatinine ratio (ACR) (p < .001) and hs-CRP levels (p = .006) were also statistically significant across the groups. ACR (HR: 1.195, 95% CI: 1.067–1.338, p = .002) and hs-CRP (HR: 2.438, 95% CI: 1.023–5.808, p = .044) were found to be related to the presence of reverse dipping blood pressure pattern.

Conclusions: The absence of nocturnal physiological dipping is seen at a remarkable rate in the normotensive Turkish population. ACR and hs-CRP are the clinical determinants related to the presence of reverse dipping blood pressure pattern.

摘要

目的：浸渍式血压模式在血压正常中的作用尚不清楚。该研究旨在在严格选择的血压正常人群中搜索昼夜血压节律和与反向倾斜模式相关的临床决定因素。

方法：根据夜间浸渍模式将研究人群分为三组，即浸渍型、非浸渍型和反向浸渍型。收集了第一天早上空腹的基础临床特征、人体测量数据和现场尿液样本。与反向倾斜模式的存在相关的临床决定因素通过多元二元逻辑回归分析进行测试。

结果：共有 233 名参与者参与了研究人群（中位年龄 45 岁 [40-50]）。在 55.4% 的研究人群中检测到浸渍模式，在 33.0% 中检测到非浸渍模式，在 11.6% 的研究人群中检测到反向浸渍模式。就基础临床特征而言，各组之间没有差异。白蛋白肌酐比值 (ACR) ( p < .001) 和 hs-CRP 水平 ( p = .006) 在各组中也具有统计学意义。发现 ACR（HR：1.195，95% CI：1.067-1.338，p = .002）和 hs-CRP（HR：2.438，95% CI：1.023-5.808，p = .044）与反向浸渍血压模式。

结论：在血压正常的土耳其人群中，夜间生理性下降的情况非常明显。ACR 和 hs-CRP 是与反向浸渍血压模式存在相关的临床决定因素。