The Association Between The Severity of Coronary Atherosclerosis and Abnormal Nocturnal Blood Pressure Variations in Hypertensive Patients

INTRODUCTION: It is well known that the hypertension and coronary artery disease show a strong cause and effect relationship, but the severity and complexity of atherosclerosis in non-dipper hypertensive patients is undefined yet. We evaluated the association between dipper or non-dipper hypertension and the extent of coronary atherosclerosis by SYNTAX score, in patients with the chronic coronary syndrome referred for percutan coronary angiography.
METHODS: Hypertensive patients that performed a percutan coronary angiography for the first time were included, and the SYNTAX score was computed. According to their ambulatory blood pressure measurements, the hypertensive patients were grouped as dippers and non-dippers.
RESULTS: One hundred and twenty-four patients were included. 87 hypertensive patients were accepted as dipper group, and 37 patients were in non-dipper hypertension group. The mean SYNTAX score for dipper group was 10.3±2.6 and 14.6±3.9 for non-dipper group (p<0.001). The number of diseased vessels is higher at the non-dipper group (1.5±1.1 versus 2.2±1.7, p<0.001). The hypertensive patients that have a high SS were more likely to be non-dipper.
DISCUSSION AND CONCLUSION: In hypertensive patients, the non-dipper pattern of nocturnal blood pressure variations is associated with more complex and severe coronary artery lesions in chronic coronary syndrome.