P3002Isolated nocturnal hypertension with morning hypertension was related with central hypertension and increased arterial stiffness

Abstract

Introduction: Recent study reported that isolated nocturnal hypertension was associated with worse cardiovascular outcomes in hypertensive patients. There are not enough studies about the inter‐relationship between isolated nocturnal hypertension/morning hypertension and central hemodynamics until now. Methods: Ambulatory blood pressure monitoring and central BP were measured in 1608 consecutive subjects enrolled in Cardiovascular and Metabolic Disease Etiology Research Center ‐ HIgh Risk Cohort (CMERC‐HI, NCT02003781). Isolated nocturnal hypertension was defined as nocturnal hypertension (mean night systolic blood pressure, SBP >120mmHg or diastolic BP, DBP >70mmHg) without daytime hypertension. Morning hypertension was defined as mean systolic BP (SBP) within 2 hours after awake >135mmHg. We divided isolated nocturnal hypertension into 2 subtypes, group I) isolated nocturnal hypertension with morning hypertension, group II) isolated nocturnal hypertension without morning hypertension. Central hypertension defined as central SBP >130mmHg or DBP >90mmHg and high risk arterial stiffness as carotid to femoral pulse wave velocity (cfPWV) >10cm/sec. Results: Nocturnal hypertension was found in 1102 (68.5%) patients and isolated nocturnal hypertension was in 344 (21.4%) patients. There were 100 (13.6%) isolated nocturnal hypertension patients with morning hypertension in our cohort. Central SBP/DBP (118/74±16/10 vs. 114/75±15/9mmHg, p=0.033 for SBP) was higher and cfPWV (9.2±2.0 vs. 8.8±1.9cm/s, p=0.110) tended to be higher in group I compared to group II. Central hypertension was higher in group I than II (20.9% vs. 12.8%, respectively, p=0.017). High risk arterial stiffness group was also higher in group I than II (29.3% vs. 20.8%, respectively, p=0.035). Conclusion: We reported that isolated nocturnal hypertension with morning hypertension was related to central hypertension and increased arterial stiffness, compared to that without morning hypertension. Further studies for assessing whether isolated nocturnal hypertension with or without morning hypertension relates to clinical outcomes should be warranted.