GW26-e0011 A prospective study on pulse wave velocity (PWV) and response to anti-hypertensive treatments: result from the China stroke primary prevention study (CSPPT)

Abstract

pattern of blood pressure (BP) may promote carotid atherosclerosis and lacunar infarction. In this study, we investigated whether RDW are elevated in hypertensive patients with reverse-dipper BP pattern compared with other circadian BP patterns. METHODS Peripheral venous blood samples were collected from all 718 hypertensive patients recruited in our study and the value of RDW was measured using an automated hematology analyzer. The hyper-tensive patients were excluded if they (1) were <18 or >90 years old; (2) had acute stroke or myocardial infarction within the past 6 months; (3) were night workers; (4) were under antihypertensive treatment; (5) had sleep apnea syndrome; (6) were diagnosed as secondary hypertension; (7) could not tolerate the 24 hours ambulatory blood pressure moni-toring (ABPM); (8) had other chronic diseases. The classification of the dipper (10-20% SBP fall), non-dipper (0-10% SBP fall), extreme-dipper (>20% SBP fall) and reverse-dipper (SBP nocturnal rise) was based on ABPM. The distribution of RDW in hy-pertensive patients among different circadian BP pattern groups was analyzed using analysis of variance (ANOVA). Multinomial logistic regression was applied to explore the associations of RDW and other relevant variables with ABPM results. RESULTS Compared with dipper group, patients with reverse-dipper pattern are more often smokers (p <0.05) and suffering diabetes (p <0.01). There was significantly increased RDW in reverse dippers (13.5AE1.05) than dippers (13.2AE0.84) of hypertension (p ¼0.007). Moreover, multinomial logistic regression analysis showed that RDW (OR 1.455, 95%CI 1.131-1.873, p ¼0.004) and diabetes (OR 2.165, 95%CI 1.327-3.533, p ¼0.002) were significantly different when comparing reverse-dipper BP pattern with dipper pattern. In addition to this, the decline rate of nocturnal SBP was negatively correlated with RDW (r ¼-0.102; p ¼0.006).