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BMC Cardiovascular Disorders

, 15:74

First Online: 22 July 2015Received: 04 May 2015Accepted: 06 July 2015DOI: 10.1186-s12872-015-0064-7

Cite this article as: Ritvo, P., Stefanyk, L.E., Azargive, S. et al. BMC Cardiovasc Disord 2015 15: 74. doi:10.1186-s12872-015-0064-7


BackgroundAbsences of normative, 10–20 % declines in blood pressure BP at night, termed nocturnal non-dipping, are linked to increased cardiovascular mortality risks. Current literature has linked these absences to psychological states, hormonal imbalance, and disorders involving hyper-arousal. This study focuses on evaluating associations between nocturnal non-dipping and indices of functional cardiac capacity and fitness.

MethodsThe current study was a cross-sectional evaluation of the associations between physical capacity variables e.g. Metabolic Equivalent MET and Maximum Heart Rate MHR, Heart rate reserve HRR, and degree of reduction in nocturnal systolic blood pressure SBP or diastolic blood pressure DBP, also known as ‘dipping’. The study sample included 96 cardiac patient participants assessed for physical capacity and ambulatory blood pressure monitoring. In addition to evaluating differences between groups on nocturnal BP ‘dipping’, physical capacity, diagnoses, and medications, linear regression analyses were used to evaluate potential associations between nocturnal SBP and DBP ‘dipping’, and physical capacity indices.

Results45 males and 14 females or 61.5 % of 96 consented participants met criteria as non-dippers <10 % drop in nocturnal BP. Although non-dippers were older p = .01 and had a lower maximum heart rate during the Bruce stress test p = .05, dipping was only significantly associated with Type 2 Diabetes co-morbidity and was not associated with type of medication. Within separate linear regression models controlling for participant sex, MHR β = 0.26, p = .01, R = .06, HRR β = 0. 19, p = .05, R = .05, and METs β = 0.21, p = .04, R = .04 emerged as significant but small predictors of degree of nighttime SBP dipping. Similar relationships were not observed for DBP.

ConclusionsSince the variables reflecting basic heart function and fitness MHR and METs, did not account for appreciable variances in nighttime BP, nocturnal hypertension appears to be a complex, multi-faceted phenomena.

KeywordsAmbulatory blood pressure monitoring Abnormal nocturnal blood pressure Nocturnal non-dipping AbbreviationsBPBlood pressure

ANBPAbnormal nocturnal blood pressure

ABPMAmbulatory blood pressure monitoring

SBPSystolic blood pressure

DBPDiastolic blood pressure

HRRHeart rate reserve

MAPMean arterial pressure

PPPulse pressure

HRHeart rate

METMetabolic equivalent

MHRMaximum heart rate

BMIBody mass index

WCWaist circumference

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Autor: Paul Ritvo - Leslie E. Stefanyk - Saam Azargive - Slobodan Stojanovic - Faye Stollon - Juda Habot - Yaariv Khaykin - Terry


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