Introduction
Materials and methods
Study population and outcomes
Statistical analysis
Results
Characteristics | Total (n = 208) | Dippers (n = 104) | Non-dippers (n = 104) | P-value |
---|---|---|---|---|
Age (years) | 58.2 + 16.7 | 53.5 + 16.9 | 63.0 + 15.0 | < 0.001 |
Male n (%) | 77 (37) | 44 (42.3) | 33 (31.7) | 0.114 |
Body weight (kg) | 65.6 + 13.4 | 67.3 + 14.0 | 63.9 + 12.6 | 0.066 |
BMI (kg/m2)* | 24.6 (21.7, 27.5) | 24.7 (21.8, 27.6) | 24.2 (21.5, 27.2) | 0.523 |
Smoking n (%) | 10 (4.8) | 10 (9.6) | 0 (0) | 0.001 |
Co-morbidities n (%) | ||||
Diabetes mellitus | 47 (22.6) | 13 (12.5) | 34 (32.7) | < 0.001 |
Dyslipidemia | 122 (58.7) | 50 (48.1) | 72 (69.2) | 0.002 |
Obstructive sleep apnea | 15 (7.2) | 8 (7.7) | 7 (6.7) | 0.789 |
Ischemic stroke | 12 (5.8) | 2 (1.9) | 10 (9.6) | 0.017 |
Coronary artery disease | 10 (4.8) | 4 (3.8) | 6 (5.8) | 0.517 |
Heart failure | 1 (0.5) | 1 (1) | 0 (0) | 1.000 |
Chronic kidney disease | 38 (18.3) | 13 (12.5) | 25 (24) | 0.031 |
Number and type of anti-hypertensive medications n (%) | 0.497 | |||
1 | 50 (24) | 24 (23.1) | 26 (25) | |
2 | 39 (18.8) | 22 (21.2) | 17 (16.3) | |
3 | 33 (15.9) | 15 (14.4) | 18 (17.3) | |
4 | 19 (9.1) | 6 (5.8) | 13 (12.5) | |
5 | 6 (2.9) | 3 (2.9) | 3 (2.9) | |
Diuretics | 28 (13.5) | 15 (14.4) | 13 (12.5) | 0.685 |
CCBs | 95 (45.7) | 40 (38.5) | 55 (52.9) | 0.037 |
ACEIs | 34 (16.3) | 18 (17.3) | 16 (15.4) | 0.708 |
ARBs | 66 (31.7) | 30 (28.8) | 36 (34.6) | 0.371 |
Beta blockers | 57 (27.4) | 22 (21.2) | 35 (33.7) | 0.043 |
Peripheral alpha-1 blockers | 27 (13) | 11 (10.6) | 16 (15.4) | 0.302 |
Central acting alpha-2 agonists | 9 (4.3) | 4 (3.8) | 5 (4.8) | 1.000 |
Direct vasodilators | 13 (6.2) | 10 (9.6) | 3 (2.9) | 0.045 |
Laboratory results | ||||
Hemoglobin (g/L)a | 132 (120, 145) | 134 (125, 148) | 130 (117, 140) | 0.006 |
Hematocrit (%) | 40.6 + 4.8 | 41.6 + 4.5 | 39.7 + 4.8 | 0.005 |
RDW (%)a | 13.6 (12.8, 14.6) | 13.4 (12.7, 14.6) | 13.7 (12.9, 14.6) | 0.225 |
MCV (fl)a | 88.5 (82.2, 91.9) | 87.8 (80.9, 91.0) | 89.1 (84.0, 92.0) | 0.162 |
NLRa | 1.80 (1.33, 2.44) | 1.79 (1.29, 2.50) | 1.85 (1.42, 2.36) | 0.623 |
PLRa | 123.25 (97.18, 161.71) | 128.39 (98.91, 166.90) | 120.95 (95.09, 158.13) | 0.353 |
Fasting plasma glucose (mmol/L)a | 5.5 (5.1, 6.3) | 5.4 (4.9, 5.9) | 5.8 (5.3, 6.4) | < 0.001 |
HbA1c (%)a | 6.0 (5.6, 6.5) | 6.0 (5.7, 6.4) | 6.0 (5.6, 6.6) | 0.655 |
Cholesterol (mmol/L) | 4.72 + 0.91 | 4.84 + 0.89 | 4.61 + 0.92 | 0.060 |
Triglyceride (mmol/L)a | 1.12 (0.88, 1.58) | 1.15 (0.92, 1.71) | 1.11 (0.87, 1.55) | 0.495 |
HDL-cholesterol (mmol/L) | 1.53 + 0.44 | 1.51 + 0.47 | 1.55 + 0.41 | 0.560 |
LDL-cholesterol (mmol/L) | 2.61 + 0.84 | 2.72 + 0.86 | 2.50 + 0.80 | 0.054 |
Uric acid (mmol/L) | 0.35 + 0.10 | 0.36 + 0.11 | 0.33 + 0.10 | 0.128 |
Abnormal proteinuria n (%) | 55 (26.4) | 20 (19.2) | 35 (33.7) | 0.346 |
Serum creatinine (μmol/L)a | 76.02 (64.53, 97.24) | 76.02 (63.65, 94.59) | 76.02 (64.53, 103.43) | 0.583 |
eGFR (ml/min/1.73 m2) | 80.22 + 24.25 | 84.69 + 22.98 | 75.75 + 24.76 | 0.008 |
Blood pressure | Total (n = 208) | Dippers (n = 104) | Non-dippers (n = 104) | P-value |
---|---|---|---|---|
Average office SBP (mmHg) | 147.3 + 17.2 | 147.7 + 17.4 | 146.8 + 17.0 | 0.719 |
Average office DBP (mmHg) | 83.1 + 11.9 | 86.0 + 12.2 | 80.2 + 10.8 | < 0.001 |
24 h average SBP (mmHg) | 128.6 + 14.7 | 128.3 + 14.1 | 128.9 + 15.4 | 0.782 |
24hourrs average DBP (mmHg) | 71.5 + 10.9 | 73.6 + 11.9 | 69.4 + 9.4 | 0.005 |
Daytime SBP (mmHg) | 132.2 + 15.5 | 134.6 + 14.9 | 129.7 + 15.8 | 0.022 |
Daytime DBP (mmHg) | 73.9 + 12.1 | 77.8 + 12.8 | 70.0 + 9.9 | < 0.001 |
Nighttime SBP (mmHg) | 121.1 + 17.1 | 114.5 + 13.5 | 127.7 + 17.9 | < 0.001 |
Nighttime DBP (mmHg) | 66.4 + 11.2 | 64.5 + 11.3 | 68.2 + 10.8 | 0.017 |
Factors | Univariable analysis | |
---|---|---|
Odds ratio (95% Confident Interval) | P value | |
Age | 1.04 (1.02–1.06) | < 0.001 |
Age > 65 years | 3.33 (1.86–5.97) | < 0.001 |
Male | 0.63 (0.36–1.12) | 0.115 |
Bodyweight | 0.98 (0.96–1.00) | 0.069 |
BMI | 0.98 (0.93–1.04) | 0.069 |
Diabetes mellitus | 3.40 (1.67–6.92) | 0.001 |
Dyslipidemia | 2.43 (1.38–4.28) | 0.002 |
Obstructive sleep apnea | 0.87 (0.30–2.48) | 0.789 |
Ischemic stroke | 5.43 (1.16–25.41) | 0.032 |
Coronary artery disease | 1.53 (0.42–5.59) | 0.520 |
Chronic kidney disease | 2.22 (1.06–4.62) | 0.034 |
Diuretics | 0.85 (0.38–1.88) | 0.848 |
CCBs | 1.80 (1.03–3.12) | 0.037 |
ACEIs | 0.87 (0.42–1.81) | 0.708 |
ARBs | 1.31 (0.73–2.35) | 0.372 |
Beta-blockers | 1.89 (1.02–3.52) | 0.045 |
Peripheral alpha-1 blockers | 1.54 (0.68–3.49) | 0.305 |
Central acting alpha-2 agonists | 1.26 (0.33–4.84) | 0.734 |
Direct vasodilators | 0.28 (0.08–1.05) | 0.058 |
Use of > 1 anti-HT medications | 1.39 (0.76–2.52) | 0.287 |
Average office SBP | 1.00 (0.98–1.01) | 0.718 |
Average office DBP | 0.96 (0.93–0.98) | 0.001 |
Hemoglobin | 0.78 (0.66–0.93) | 0.004 |
Hematocrit | 0.92 (0.86–0.98) | 0.006 |
RDW | 1.01 (0.86–1.19) | 0.923 |
MCV | 1.01 (0.98–1.04) | 0.392 |
NLR | 1.10 (0.88–1.37) | 0.405 |
PLR | 1.00 (1.00–1.01) | 0.314 |
Fasting plasma glucose | 1.02 (1.01–1.04) | 0.006 |
Fasting plasma glucose > 5.6 mmol/L | 2.74 (1.56–4.81) | < 0.001 |
HbA1c | 1.40 (0.93–2.11) | 0.112 |
Cholesterol | 0.99 (0.99–1.000) | 0.062 |
Triglyceride | 1.00 (0.99–1.00) | 0.269 |
HDL-cholesterol | 1.01 (0.98–1.02) | 0.558 |
LDL-cholesterol | 0.99 (0.98–1.00) | 0.055 |
Uric acid | 0.87 (0.72–1.04) | 0.129 |
Abnormal proteinuria | 1.37 (0.71–2.64) | 0.346 |
Serum creatinine | 1.19 (0.61–2.32) | 0.620 |
eGFR | 0.98 (0.973–1.00) | 0.009 |
Factors | Multivariable analysis | |
---|---|---|
Odds ratio (95% Confident Interval) | P value | |
Age > 65 years | 2.31 (1.10–4.82) | 0.026 |
Diabetes mellitus | 1.10 (0.43–2.82) | 0.846 |
Dyslipidemia | 1.45 (0.71–2.94) | 0.309 |
Ischemic stroke | 3.85 (0.70–21.22) | 0.122 |
CCBs | 1.02 (0.49–2.09) | 0.966 |
Beta blockers | 1.07 (0.50–2.28) | 0.863 |
Average office DBP | 0.96 (0.94–0.99) | 0.016 |
Hemoglobin | 0.85 (0.70–1.03) | 0.090 |
Fasting plasma glucose > 5.6 mmol/L | 2.15 (1.04–4.47) | 0.040 |
eGFR | 1.00 (0.99–1.02) | 0.721 |
Subgroup analysis by treatment status of hypertension
Factors | Multivariable analysis | |
---|---|---|
Odds ratio (95% CI) | P value | |
Age | 1.011 (0.952–1.074) | 0.721 |
Male | 4.320 (0.611–30.564) | 0.143 |
BMI | 0.978 (0.845–1.133) | 0.770 |
Diabetes mellitus | 2.483 (0.347–17.764) | 0.365 |
Dyslipidemia | 11.773 (1.785–77.641) | 0.010 |
Obstructive sleep apnea | 1.505 (0.069–32.933) | 0.795 |
Coronary artery disease | 0.031 (0.001–0.924) | 0.045 |
Diuretics | 0.224 (0.026–1.938) | 0.174 |
CCBs | 1.788 (0.365–8.757) | 0.473 |
ACEIs | 0.076 (0.010–0.572) | 0.012 |
ARBs | 0.423 (0.081–2.197) | 0.306 |
Beta-blockers | 2.091 (0.486–9.003) | 0.322 |
Peripheral alpha-1 blockers | 1.446 (0.175–11.932) | 0.732 |
Central acting alpha-2 agonists | 0.737 (0.028–19.498) | 0.855 |
Direct vasodilators | 0.038 (0.002–0.743) | 0.031 |
Evening drug administration | 1.584 (0.395–6.355) | 0.517 |
Average office SBP | 1.052 (0.992–1.115) | 0.092 |
Average office DBP | 0.886 (0.818–0.959) | 0.003 |
Hemoglobin | 0.843 (0.507–1.399) | 0.508 |
RDW | 0.670 (0.401–1.120) | 0.126 |
MCV | 0.941 (0.842–1.052) | 0.287 |
NLR | 0.949 (0.386–2.331) | 0.909 |
PLR | 1.001 (0.995–1.007) | 0.760 |
Fasting plasma glucose | 0.972 (0.934–1.012) | 0.168 |
Cholesterol | 0.987 (0.910–1.069) | 0.744 |
Triglyceride | 0.996 (0.971–1.024) | 0.818 |
HDL-cholesterol | 0.980 (0.893–1.075) | 0.672 |
LDL-cholesterol | 1.014 (0.939–1.095) | 0.720 |
Uric acid | 0.615 (0.407–0.932) | 0.022 |
Abnormal proteinuria | 1.552 (0.306–7.871) | 0.596 |
eGFR | 0.999 (0.953–1.047) | 0.966 |
Factors | Multivariable analysis | |
---|---|---|
Odds ratio (95% CI) | P value | |
Age | 1.030 (0.917–1.157) | 0.616 |
Male | 1.200 (0.069–20.840) | 0.901 |
BMI | 1.055 (0.857–1.298) | 0.614 |
Diabetes mellitus | 0.022 (0.000–6.512) | 0.189 |
Dyslipidemia | 0.669 (0.019–23.167) | 0.824 |
Average office SBP | 0.943 (0.866–1.027) | 0.175 |
Average office DBP | 1.087 (0.954–1.239) | 0.209 |
Hemoglobin | 0.285 (0.073–1.117) | 0.072 |
RDW | 1.046 (0.358–3.056) | 0.935 |
MCV | 1.257 (0.944–1.675) | 0.117 |
NLR | 0.660 (0.153–2.846) | 0.577 |
PLR | 1.032 (0.991–1.074) | 0.129 |
Fasting plasma glucose | 1.036 (0.943–1.140) | 0.459 |
Cholesterol | 1.051 (0.688–1.606) | 0.817 |
Triglyceride | 0.999 (0.914–1.092) | 0.985 |
HDL-cholesterol | 0.894 (0.595–1.341) | 0.588 |
LDL-cholesterol | 0.932 (0.614–1.417) | 0.744 |
eGFR | 1.006 (0.896–1.130) | 0.916 |
Abnormal proteinuria | 2.216 (0.033–151.082) | 0.712 |
The predictive score for non-dipper stratified by hypertensive treatment status
Factors | β co-efficient | P-value* |
---|---|---|
Average office DBP | −0.081 | 0.001 |
Dyslipidemia | 1.474 | 0.008 |
Serum uric acid | −0.297 | 0.046 |
Use of CCBs | 1.031 | 0.059 |
Use of ACEIs | −0.986 | 0.087 |
Male | 0.746 | 0.172 |
Constant | 7.000 | 0.001 |
Factors | β co-efficient | P-value* |
---|---|---|
Age | 0.030 | 0.114 |
Body mass index | −0.093 | 0.146 |
Hemoglobin | −0.379 | 0.064 |
Constant | 5.443 | 0.120 |