Nocturnal Hypertension Correlates Better With Target Organ Damage in Patients With Chronic Kidney Disease than a Nondipping Pattern

Abstract

Both nocturnal hypertension and nondipping pattern are associated with target organ damages (TODs); however, no data exist with respect to Chinese patients with chronic kidney disease (CKD). The authors recruited 1322 patients with CKD admitted to our hospital division and referred with data in this cross-sectional study. Patients with nocturnal systolic hypertension had a lower estimated glomerular filtration rate (eGFR) and higher left ventricular mass index (LVMI) and carotid intima-media thickness (cIMT) compared with patients with normal nocturnal systolic blood pressure (SPB; all, P<.001), while patients in the dipper and nondipper groups had similar levels of eGFR, LVMI, and cIMT when the patients had a similar nocturnal SBP. Factorial-designed analysis of variance indicated that the main effect of nocturnal SBP was significant for all TOD differences (all, P<.001), but no significance existed with respect to the main effect of the dipper pattern and an interaction between the two factors (all, P>.05). Nocturnal systolic hypertension, rather than nondipping pattern, was an independent risk factor for TOD in CKD patients. Nocturnal hypertension, rather than a nondipping pattern, was better associated with TOD in CKD patients.

© 2015 Wiley Periodicals, Inc.

Figures

Figure 1

Comparison of target organ damages in four groups with normal nocturnal systolic blood pressure (SBP) or nocturnal systolic hypertension and dipper or nondipper pattern (by Bonferroni method [six comparisons]). *Comparison with the normal nocturnal SBP and dipper groups (P<.05). #Comparison with the normal nocturnal SBP and nondipper groups (P<.05). $Comparison with the nocturnal systolic hypertension and dipper groups (P<.05). LVH indicates left ventricular hypertrophy; cIMT, carotid intima‐media thickness.