Background
It is well established that an exaggerated morning blood pressure surge (MBPS) is
associated with an increased risk for cardiovascular disease development in hypertensive
individuals. However, in non-dipping individuals, a lower surge was reportedly associated
with increased cardiovascular risk. Sympathetic nervous system activity is involved
in 24-hour blood pressure fluctuations, including night-time dipping and the MBPS.
To better understand this interaction, we investigated associations of MBPS with heart-rate
variability and baroreceptor sensitivity in young healthy dippers and non-dippers.
Methods
We included black and white men and women (n = 827), aged 20-30 years and determined the MBPS using two formulas: the sleep-trough
and dynamic morning surge. For autonomic function we determined baroreceptor sensitivity
and heart-rate variability.
Results
The majority of non-dippers in this population were black (70.4%), presenting lower
sleep-trough and dynamic morning surge (all p < 0.001). Heart-rate variability was comparable between dippers and non-dippers, whereas
baroreceptor sensitivity was higher in non-dippers (p = 0.021). Despite a suppressed MBPS profile in non-dippers, we found both sleep-trough
(β = −0.25; p = 0.039) and dynamic morning surge (β = −0.14; p = 0.047) to be inversely and independently associated with 24-hour heart-rate variability
(total power). These results were absent in dippers.
Conclusions
In conclusion, we found a higher night-time blood pressure coupled with lower MBPS
in young healthy non-dippers. Furthermore, this lower MBPS was independently and negatively
associated with autonomic neural activity, suggesting increased autonomic function
involvement in MBPS suppression of non-dippers. The predictive value of suppressed
nocturnal dipping pattern should be investigated while taking autonomic neural activity
into account.
Keywords
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Article info
Publication history
Published online: July 27, 2018
Accepted:
July 4,
2018
Received in revised form:
May 24,
2018
Received:
April 23,
2018
Identification
Copyright
© 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
