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

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1157-1163
Number of pages7
JournalHypertension
Volume59
Issue number6
DOIs
StatePublished - Jun 2012

Keywords

  • Ambulatory blood pressure
  • Blood pressure dipping
  • Coronary artery calcium
  • Diurnal blood pressure
  • Subclinical atherosclerosis

Fingerprint Dive into the research topics of 'Nighttime blood pressure dipping in young adults and coronary artery calcium 10-15 years later: The coronary artery risk development in young adults study'. Together they form a unique fingerprint.

Cite this