INFLAMMATION MARKERS IN SUBJECTS WITH DIPPER AND NON-DIPPER BLOOD PRESSURE PATTERNS

Objective: Elevated inflammation markers play important role in vessels damage and remodeling in patients with hypertension. However, the data are limited concerning the association between blood pressure circadian rhythm and inflammation status, especially in early changes of a pattern of blood pressure circadian rhythm in normotensive subjects. The aim of the work was to study the connection between dipper and non-dipper patterns of blood pressure circadian variation and inflammatory markers in normotensive and hypertensive subjects. Design and method: The cross-sectional study included 125 hypertensive patients (54 men) with an age median of 56,5 [45.0 ÷ 63.7] years old and 41 normotensive subjects 52,1 [41.5 ÷ 61.2] years old. All hypertensive patients had been on stable antihypertensive therapy during the last three months and had target blood pressure at the moment of inclusion to the study. Ambulatory blood pressure monitoring was done to all patients with Heaco ABPM50 monitoring. Fasting glucose, blood lipids, creatinine, uric acid, high sensitive C-reactive protein (hCRP), and interleukin 1 beta (IL-1B) were measured. Physical activity was assessed using the International Physical Activity Questionnaire. Data were analyzed with SPSS IBM 19.0. Results: Parameters of ambulatory blood pressure monitoring are presented in the table1 1. Normotensive subjects had lower BMI than hypertensive patients (26,1 [23,5–28,4] vs 35,3 [31,0–37,9]), p = 0.03, Mann-Whitney). It was found out that hCRP was significantly higher in a non-dipper subgroup of hypertensive patients (7.43[3.26–11.45] vs 9.50[7.70–15.87], p = 0.01, Mann-Whitney) as well as in the non-dipper subgroup of normotensive patients (2.37[0.97–4.75] vs 2.87[1.84–523], p = 0,03, Mann-Whitney). There was no significant difference in interleukin-1b level in dipper and non-dipper normotensive patients (2.10 [1.63–2.65] vs 1.8 [1.55–2.10], p = 4.13, Mann-Whitney). However, in hypertensive patients with non-dipper patterns, interleukin-1b was significantly higher, than in dipper patients (2.21 [1.62–2.77] vs 2.26 [2.0–3.11], p = 0.03, Mann-Whitney). Conclusions: Non-dipper pattern of blood pressure circadian rhythm is associated with increased inflammatory markers in hypertensive patients as well as in normotensive subjects.