[Circadian blood pressure characteristics in hospitalized unstable angina pectoris patients with hypertension].

Objective

To define the characteristic of circadian rhythm of blood pressure in unstable angina pectoris (UAP)patients with hypertension and its effects on the cardiovascular events.

Methods

It was a prospective study.Based on coronary angiographic results, 742 consecutive hospitalized UAP patients with hypertension and 89 consecutive hospitalized hypertensive patients were recruited between September 2014 and December 2015 in this study. Clinical data and the results of 24-hour ambulatory blood pressure monitoring (ABPM) were analyzed.

Results

The total prevalence of hypertension in UAP is about 77.1%(742/962) in our cohort. The decrease of night-time systolic and diastolic blood pressure in UAP patients complicated with hypertension was lower than that in hypertensive patients (P<0.05). The prevalence of dipper, non-dipper and reverse dipper pattern was 12.4%(92/742), 34.9%(259/742) and 52.7%(391/742) in UAP patients complicated with hypertension, 18.0%(16/89), 48.3%(43/89) and 33.7%(30/89) in hypertensive patients. Obviously, the abnormal circadian rhythm of blood pressure was more significant in UAP patients with hypertension than in hypertensive patients, characterized by higher reverse dipper pattern in UAP patients with hypertension compared to patients with hypertension(P=0.00), similar results were evidenced among the male and female patients and patients with various ages. Subgroup analysis showed that except similar results on the incidence of reverse dipper pattern in controlled blood pressure aged less than 45 years old, the incidence of reverse dipper pattern was all significantly higher in UAP patients complicating with hypertension than in hypertensive patients independent no matter blood pressure controlled or not (all P<0.05). After adjustment for sex, age, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and other risk factors, binary logistic regression analysis showed that reverse dipper pattern was independently associated with UAP(OR=1.53, 95%CI 1.12-2.61).

Conclusions

This finding suggests that UAP patients with hypertension often have abnormal circadian rhythm, characterized by higher reverse dipper circadian pattern. Elevated nocturnal blood pressure is independently related to UAP.