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Nighttime Blood Pressure Dipping in Young Adults and Coronary Artery Calcium 10–15 Years Later: The Coronary Artery Risk Development in Young Adults Study

Anthony J. Viera; Feng-Chang Lin; Alan L. Hinderliter; Daichi Shimbo; Sharina D. Person; Mark J. Pletcher; David R. Jacobs Jr.

Title:
Nighttime Blood Pressure Dipping in Young Adults and Coronary Artery Calcium 10–15 Years Later: The Coronary Artery Risk Development in Young Adults Study
Author(s):
Viera, Anthony J.
Lin, Feng-Chang
Hinderliter, Alan L.
Shimbo, Daichi
Person, Sharina D.
Pletcher, Mark J.
Jacobs Jr., David R.
Date:
Type:
Articles
Department(s):
Center for Behavioral Cardiovascular Health
Volume:
59
Persistent URL:
Book/Journal Title:
Hypertension
Publisher:
American Heart Association
Abstract:
Nighttime blood pressure (BP) dipping can be quantified as the ratio of mean nighttime (sleep) BP to mean daytime (awake) BP. People whose dipping ratio is ≥0.90 have been referred to as nondippers, and nondipping is associated with cardiovascular disease events. We examined the relationship between systolic nighttime BP dipping in young adults and the presence of coronary artery calcium (CAC) 10 to 15 years later using data from the ambulatory BP monitoring substudy of the Coronary Artery Risk Development in Young Adults Study. Among 239 participants with adequate measures of both nighttime and daytime readings and coronary artery calcium, the systolic BP dipping ratio ranged from 0.72 to 1.24 (mean, 0.88; SD, 0.06), and CAC was present 10 to 15 years later in 54 participants (22.6%). Compared with those whose systolic BP dipping ratio ranged from 0.88 to 0.92 (quartile 3), the 57 participants (23.9%) with less pronounced or absent dipping (ratio, 0.92–1.24; quartile 4) had an unadjusted odds ratio of 4.08 (95% CI, 1.48–11.2) for the presence of CAC. The 60 participants (25.1%) with a more pronounced dipping (ratio, 0.72–0.85; quartile 1) also had greater odds for presence of CAC (odds ratio, 4.76 [95% CI, 1.76–12.9]). When modeled as a continuous predictor, a U-shaped relationship between systolic BP dipping ratio and future CAC was apparent and persisted after adjustment for multiple potential confounders (P<0.001 for quadratic term). Both failure of systolic BP to dip sufficiently and “overdipping” during nighttime may be associated with future subclinical coronary atherosclerosis.
Subject(s):
Calcium in the body
Atherosclerosis--Risk factors
Blood pressure--Measurement
Medical sciences
Medicine
Epidemiology
Publisher DOI:
https://doi.org/10.1161/HYPERTENSIONAHA.112.191536
Item views
328
Metadata:
text | xml
Suggested Citation:
Anthony J. Viera, Feng-Chang Lin, Alan L. Hinderliter, Daichi Shimbo, Sharina D. Person, Mark J. Pletcher, David R. Jacobs Jr., , Nighttime Blood Pressure Dipping in Young Adults and Coronary Artery Calcium 10–15 Years Later: The Coronary Artery Risk Development in Young Adults Study, Columbia University Academic Commons, .

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