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Is Isolated Nocturnal Hypertension a Novel Clinical Entity? Findings From a Chinese Population Study
[2007/8/28 14:26:00]
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Is Isolated Nocturnal Hypertension a Novel Clinical Entity? Findings From a Chinese Population Study

Y. Li1, J.A. Staessen2, L. Lu1, G.L. Wang1, J.G. Wang1
1 Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China
2 Studies Coordinating Centre, Department of Cardiovascular Diseases, University of Leuven, Belgium

Objectives: We previously reported that normotensive Chinese had higher nighttime diastolic pressure (BP) compared to non-Chinese. We therefore studied the prevalence and characteristics of isolated nocturnal hypertension (HT) and its association with arterial stiffness, an intermediate sign of target organ damage.

Methods: We recorded ambulatory BP, the central (CAI) and peripheral (PAI) systolic augmentation indexes, the ambulatory arterial stiffness index (AASI), and brachial-ankle pulse wave velocity (baPWV) in 677 Chinese enrolled in the JingNing population study(53.6% women; mean age,47.6 years).

Results: Prevalence was 10.9% for isolated nocturnal HT (≥120/70mmHg from 22:00h to 04:00h), 4.9% for isolated daytime HT (≥135/85mmHg from 08:00h to 18:00h), and 38.4% for day-night HT. Patients with isolated nocturnal HT, compared to subjects with ambulatory normotension (45.8%), were older (53.7 vs. 40.7 years), more often reported alcohol intake (68.9% vs. 51.0%), had faster nighttime pulse rate (62.8 vs. 60.7 beat/min), higher serum cholesterol (5.12 vs. 4.77 mmol/L) and blood glucose(4.84 vs. 4.38 mmol/L), similar to patients with isolated daytime HT or day-night HT, patients with isolated nocturnal HT had higher indexes of arterial stiffness (P<0.05) than subjects with ambulatory normotension (CAI, 140% vs. 134% ; PAI, 82.6% vs. 76.5%; AASI ,0.40 vs. 0.35 units; baPWV, 16.2 vs. 14.7m/s). Of 74 patients with isolated nocturnal HT, only 4 (5.4%) had hypertension on conventional office BP measurement(≥140/90 mm Hg).
Conclusion: Isolated nocturnal HT can only be diagnosed by ambulatory BP monitoring, is prevalent among Chinese, and is associated with increased arterial stiffness.





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