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Abstract: FR-PO1031

Patterns of Nocturnal Blood Pressure Changes in Patients on Ambulatory Blood Pressure Monitoring (ABPM) in Patients with Complex Hypertension

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Agarwal, Neil Kumar, Drexel University College of Medicine, Rose Valley, Pennsylvania, United States
  • Elraiyah, Tarig, Drexel University College of Medicine, Rose Valley, Pennsylvania, United States
  • Akbar, Siddique, Drexel University College of Medicine, Rose Valley, Pennsylvania, United States
  • Ahmed, Ziauddin, Drexel University College of Medicine, Rose Valley, Pennsylvania, United States
  • Kelepouris, Ellie, Drexel University College of Medicine, Rose Valley, Pennsylvania, United States
  • Aggarwal, Sandeep, Drexel University College of Medicine, Rose Valley, Pennsylvania, United States
Background

Nocturnal blood pressure changes are associated with patient centered outcomes. We attempted to investigate the patterns of blood pressure changes in complex hypertensive patients with concomitant cardiovascular comorbidities.

Methods

We retrospectively reviewed 35 charts of patients who received ABPM from a single outpatient nephrology office. Of the 35, 3 were excluded due to incomplete data. We collected demographic information: Age, Gender, Ethnicity, Diabetic status, CKD stage, Indication for ABPM. ABPM data Including: Average daytime pressures, Average nighttime pressures, total average pressures, nocturnal dipping, hypertensive load. IBM SPSS® v22 was used for statistical analysis – t-tests.

Results

Of the 32 patients (22 Female, 10 Male), 20 were African American, 6 were diabetic, 17 had CKD stage 3 or greater, and mean age was 56±19 years. Among CKD patients, the mean nocturnal systolic dip was 3.4±9.8mmHg, mean diastolic nocturnal dip 8.2±8.3mmHg, mean MAP nocturnal dip 5.9±9.2mmHg. Among non-CKD patients, the mean systolic nocturnal dip was 6.9±5.8mmHg, mean diastolic nocturnal dip 11.9±6.5mmHg, mean MAP nocturnal dip 9.6±6.2mmHg. The mean difference between systolic nocturnal dip was 3.5±2.9 mmHg (p=0.2433), mean difference between diastolic nocturnal dip was 3.7±2.7mmHg (p=0.1708), mean difference between MAP nocturnal dip was 3.6±2.8 mmHg (p=0.2034). Among diabetic patients, the mean systolic nocturnal dip was 5.8±8.9mmHg, mean diastolic nocturnal dip 11.2±7.6mmHg, mean MAP nocturnal dip 8.8±8.2mmHg. The mean difference between systolic nocturnal dip was 3.8±3.7 mmHg (p=0.3148), mean difference between diastolic nocturnal dip was 7.1±3.3mmHg (p=0.0376), mean difference between MAP nocturnal dip was 6.2±3.5 mmHg (p=0.0864).

Conclusion

In our study, there was no difference in nocturnal blood pressure changes in patients with or without cardiovascular co-morbidities, except for nocturnal diastolic blood pressure in diabetic patients. Additional, larger scale trials are required to look for additional or synergistic risk of nocturnal blood pressure variability in patients with high cardiovascular risk.