Scanty information is available about the association of isolated daytime hypertension (IDH) and isolated night-time hypertension (INH) with subclinical cardiac damage in the general population. We examined this issue in patients enrolled in the Pressioni Arteriose Monitorate E Loro Associazioni study.
The analysis included 2021 participants with valid ambulatory blood pressure (BP) monitoring at baseline evaluation. IDH and INH were defined according to current guidelines. Subclinical organ damage was assessed by validated electrocardiographic and echocardiographic criteria.
A total of 1258 patients (62.3%) had daytime/night-time normotension, 376 (18.6%) daytime/night-time hypertension, 231 (11.4%) INH and 156 (7.7%) IDH, respectively. Participants with hypertension, compared with their normotensive counterparts were older, included a higher fraction of men, had higher BMI, LDL cholesterol, triglyceride and glucose levels and exhibited a greater subclinical cardiac involvement. Furthermore, INH and IDH patients showed a similar degree of cardiac damage (i.e. left ventricular mass index: 89 ± 18 vs 90 ± 20 g/m2), intermediate between normotensive (82 ± 19 g/m2) and day–night hypertensive patients (99 ± 24 g/m2).
The present study shows that IDH and INH exert similar detrimental effects on cardiac structure. In a practical perspective, appropriate antihypertensive chrono-therapeutic approaches in these opposite ambulatory hypertensive subtypes may have important implications in cardiovascular prevention.
aDepartment of Health Science, University of Milano-Bicocca
bIstituto Auxologico Italiano IRCCS
cDepartment of Clinical Sciences and Community Health University of Milano and Fondazione Ospedale Maggiore Policlinico, Milano, Italy
dUniversity Clinical Hospital Centre ‘Dragisa Misovic’, Belgrade, Serbia
eIRCCS Multimedica, Sesto San Giovanni, Milano, Italy
Correspondence to Prof Cesare Cuspidi, MD, Istituto Auxologico Italiano, Clinical Research Unit, Viale della Resistenza 23, 20036 Meda, Italy. Tel: +0039 0362 772433; fax: +0039 0362 772416; e-mail: firstname.lastname@example.org
Abbreviations: ABPM, ambulatory blood pressure monitoring; BP, blood pressure; IDH, isolated daytime hypertension; INH, isolated night-time hypertension; IVS, interventricular septum; LV, left ventricular; LVEDD, LV end-diastolic diameter; LVH, left ventricular hypertrophy; LVM, left ventricular mass; PAMELA, Pressioni Monitorate e Loro Associazioni study; PWT, posterior wall thickness
Received 30 July, 2016
Revised 1 October, 2016
Accepted 28 October, 2016