Determinants of reverse dipping blood pressure in normotensive, non-diabetic population with an office measurement below 130/85mmHg

Coner A., Akbay E., AKINCI S., Ozyildiz G., Genctoy G., Muderrisoglu H.

CLINICAL AND EXPERIMENTAL HYPERTENSION, vol.43, no.7, pp.647-652, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 43 Issue: 7
  • Publication Date: 2021
  • Doi Number: 10.1080/10641963.2021.1925685
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, Food Science & Technology Abstracts, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.647-652
  • Keywords: Ambulatory blood pressure monitoring, circadian blood pressure rhythm, nocturnal dipping pattern, reverse dipping blood pressure, target organ damage, CELL DISTRIBUTION WIDTH, PROGNOSTIC-SIGNIFICANCE, HYPERTENSIVE PATIENTS, MASKED HYPERTENSION, URIC-ACID, PATTERN, INFLAMMATION, DYSFUNCTION, DAYTIME, RHYTHM
  • Recep Tayyip Erdoğan University Affiliated: Yes


Objective: The role of dipping blood pressure pattern in normotensives is unclear. The study aims to search the circadian blood pressure rhythm and the clinical determinants related to reverse dipping pattern in a strictly selected, normotensive population. Methods: The study population was divided into three groups depending on the nocturnal dipping pattern as dipping, non-dipping, and reverse dipping. Basal clinical characteristics, anthropometric measurements, and spot urine samples from the first-morning void were collected. Clinical determinants related to the presence of reverse dipping pattern were tested by the Multiple Binary Logistic Regression analysis. Results: A total of 233 participants were involved in the study population (median age 45 years [40-50]). Dipping pattern was detected in 55.4%, non-dipping pattern in 33.0%, and reverse dipping pattern in 11.6% of the study population. There was no difference between the groups in terms of basal clinical features. Albumin-to-creatinine ratio (ACR) (p < .001) and hs-CRP levels (p = .006) were also statistically significant across the groups. ACR (HR: 1.195, 95% CI: 1.067-1.338, p = .002) and hs-CRP (HR: 2.438, 95% CI: 1.023-5.808, p = .044) were found to be related to the presence of reverse dipping blood pressure pattern. Conclusions: The absence of nocturnal physiological dipping is seen at a remarkable rate in the normotensive Turkish population. ACR and hs-CRP are the clinical determinants related to the presence of reverse dipping blood pressure pattern.