Midtveisevaluering - Sahrai Saeed

ABSTRACT

Background: Abnormal night-time blood pressure (BP) decline is associated with increased cardiovascular risk in hypertension. Little is known about the prevalence and covariates of night-time BP reduction in ischemic stroke patients.

Methods: Clinic and ambulatory BP measurements were recorded in 268 patients (aged 15-60 years) included in the Norwegian Stroke in the Young Study. The percent reduction in nocturnal BP was calculated from mean BP and defined as non-dipping if <10%. Arterial stiffness was derived from carotid-femoral pulse wave velocity (PWV) using applanation tonometry.

Results: Non-dipping pattern was found in 38%. Non-dippers had higher PWV (8.2±2.2 vs. 7.5±1.7 m/s), mean carotid intima-media thickness (IMT) (0.9±0.2 vs. 0.8±0.3 mm), night-time BP, reduced renal function, and included more patients with known hypertension (48 vs. 23%) and diabetes (15 vs. 8%, all P<0.05). Furthermore, 26% of non-dippers had high for age PWV, reflecting early arterial stiffening. Elevated night-time BP was present in 80% of non-dippers and associated with higher carotid IMT and PWV (all P<0.01). In multivariate logistic regression analyses, non-dipping was associated with high for age PWV (OR 2.28 [95% CI 1.06-4.92], P<0.05) independent of known hypertension and other confounder

Conclusions: In the Norwegian Stroke in the Young Study, non-dipping is common and associated with premature arterial stiffness and pre-cerebral arterial remodeling.