Relationship Between Metabolic Syndrome and Non-Dipping Blood Pressure Pattern in Obese Patient

Year 2013, , 28 - 31, 01.01.2013

Ahmet Yılmaz Alim Erdem Hekim Karapınar Zekeriya Küçükdurmaz İbrahim Gül Osman Can Yontar

https://doi.org/10.5505/abantmedj.2013.83997

Abstract

Background: Metabolic syndrome and non-dipping blood pressure pattern are related with cardiovascular disease. It is considered that there may be common pathophysiological mechanisms of these clinical entities. We aimed to investigate the association between metabolic syndrome and nondipping blood pressure pattern. Method: 118 consecutive newly diagnosed metabolic syndrome patients with obesity who underwent 24-hour ambulatory blood pressure monitoring were included in the study. They were divided into dipper n = 46 and non-dipper n = 72 groups. Nocturnal non-dipping blood pressure pattern is defined as the lower than 10 % reduction in nocturnal mean systolic and/or diastolic blood pressure. Results: In the whole population, mean 24-hour ambulatory blood pressure was 146/96 mmHg. Although, the two groups was similar in terms of basic characteristics; the frequency of metabolic syndrome was significantly greater in patients with non-dipping pattern p=0.038 . Conclusion: In this study metabolic syndrome was found to be more prevalent among patients with non-dipping pattern of hypertension. This may indicate a common pathophysiologic mechanism of metabolic syndrome and non-dipping blood pressure pattern in obese patient

Keywords

Metabolic syndrome, non-dipping blood pressure pattern, ambulatory blood pressure monitoring

Obez Hastalarda Non-Dipper Kan Basıncı ile Metabolik Sendrom Arasındaki İlişki

Abstract

OBJECTIVE: Metabolic syndrome and non-dipping blood pressure pattern are related with cardiovascular disease. It is considered that there may be common pathophysiological mechanisms of these clinical entities. We aimed to investigate the association between metabolic syndrome and non-dipping blood pressure pattern.METHODS: 118 consecutive newly diagnosed metabolic syndrome patients with obesity who underwent 24-hour ambulatory blood pressure monitoring were included in the study. They were divided into dipper n = 46 and non-dipper n = 72 groups. Nocturnal non-dipping blood pressure pattern is defined as the lower than 10 % reduction in nocturnal mean systolic and/or diastolic blood pressure. RESULTS: In the whole population, mean 24-hour ambulatory blood pressure was 146/96 mmHg. Although, the two groups was similar in terms of basic characteristics; the frequency of metabolic syndrome was significantly greater in patients with non-dipping pattern p=0.038 .CONCLUSION: In this study metabolic syndrome was found to be more prevalent among patients with non-dipping pattern of hypertension. This may indicate a common pathophysiologic mechanism of metabolic syndrome and non-dipping blood pressure pattern in obese patient.

Keywords

Metabolik sendrom, non-dipper kan basıncı, ambulatuar kan basıncı izlemi

References

• Pickering, TG. The clinical significance of diurnal blood pressure variations. Dippers and nondip- pers. Circulation 1990. 81: 700–702.
• O'Brien, E., Sheridan, J., O'Malley, K. Dippers and non-dippers. Lancet.1988. 13: 397
• Güngör A, Aydın Y, Celbek G, Başar C, Alemdar R, Ordu S, Yıldırım HA, Özhan H. Asymmetric dime- thylarginine levels in dipper and nondipper hyper- tensive patients. Dicle Medical Journal 2010; 37: 332-338.
• Pierdomenico SD, Bucci A, Costantini F, Lapenna D, Cuccurullo F, Mezzetti A. Circadian blood pres- sure changes and myocardial ischemia in hyper- tensive patients with coronary artery disease. J Am Coll Cardiol. 1998;31:1627-34.
• Lurbe E, Redon J, Pascual JM, Tacons J, Alvarez V. The spectrum of circadian blood pressure changes in type I diabetic patients. J Hypertens. 2001;19:1421-8.
• Björntorp P, Rosmond R. The metabolic syndrome- -a neuroendocrine disorder? Br J Nutr. 2000;83 Suppl 1:S49-57.
• Uzun G, Karagoz H, Mutluoglu M, Ozdemir Y, Uz O, Senol MG. Non-invasive blood pressure cuff in- duced lower extremity wound in a diabetic pa- tient. Eur Rev Med Pharmacol Sci. 2012;16:707-8.
• Pickering TG. The clinical significance of diurnal blood pressure variations, dippers and nondip- pers. Circulation 1990; 81: 700–702.
• Mann S, Altman DJ, Raftery EB, Bannister R. Circa- dian variation of blood pressure in autonomic fail- ure. Circulation 1983; 68: 477–483.
• Holl RW, Pavlovic M, Heinze E, Thon A. Circadian blood pressure during the early course of type 1 diabetes. Analysis of 1011 ambulatory blood pres- sure recordings in 354 adolescents and young adults. Diabetes Care 1999; 22: 1151–1157.
• Bianchi S, Bigazzi R, Baldari G, Sgherri G, Campese VM. Diurnal variations of blood pressure and mi- croalbuminuria in essential hypertension. Am J Hypertens 1994 ;7:23-9.
• Schillaci G, Pirro M, Vaudo G et al. Prognostic value of the metabolic syndrome in essential hy- pertension. J Am Coll Cardiol 2004; 43: 1817–22.
• Reaven GM. Role of insulin resistance in human disease (syndrome X): an expanded definition. Annu Rev Med. 1993;44:121-31.
• D.A. de Luis, R. Aller, O. Izaola, M. Gonzalez Sa- grado, R. Conde, M.J. Castro. Interaction of -55CT polymorphism of UCP3 gene with Trp64Arg poly- morphism of beta3adrenoreceptor gene on insulin resistance in obese patients. Eur Rev Med Phar- macol Sci 2012; 16: 610-616.
• Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complica- tions. Part 1: diagnosis and classification of diabe- tes mellitus, provisional report of a WHO consulta- tion. Diabet Med 1998;15:539-53.
• WHO Consultation. Definition, diagnosis and clas- sification of diabetes mellitus and its complica- tions. Part 1: diagnosis and classification of diabe- tes mellitus. Geneva: World Health Organisation, Geneva;1999.
• Laitinen, T., Lindström, J., Eriksson, J., Ilanne- Parikka, P., Aunola, S., Keinänen-Kiukaanniemi, S., Tuomilehto, J. and Uusitupa, M. Cardiovascular autonomic dysfunction is associated with central obesity in persons with impaired glucose toler- ance. Diabet Med. 2011;28:699-704.
• Piccirillo G, Vetta F, Viola E, Santagada E, Ronzoni S, Cacciafesta M. Heart rate and blood pressure variability in obese normotensive subjects. Int J Obes Relat Metab Disord 1998; 22: 741–750.
• Grassi G, Dell’Oro R, Facchini A, Quarti Trevano F, Bolla GB, Mancia G. Effect of central and peripher- al body fat distribution on sympathetic and baro- reflex function in obese normotensives. J Hyper- tens 2004; 22: 2363–2369.