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Background: In healthy individuals, blood pressure follows a circadian pattern with typically a 10% or more drop in blood pressure nocturnally. Individuals with a lack of nocturnal dipping or rises in nocturnal blood pressure from daytime have an increased risk of hypertensive complications. In this study, we examine a potential correlation between obesity and nocturnal blood pressure abnormalities, including blood pressure non-dipping, and a rise of blood pressure nocturnally, as well as the impact of weight reduction through dietary intervention, on nocturnal blood pressure.
Methods: We recruited 30 volunteers with a lack of nocturnal dip pattern, 30 volunteers with blood pressure that rises nocturnally from daytime and 20 control volunteers with a healthy nocturnal dip. Individuals with known sleep apnea were excluded. 24-hour ABPM and BMI measurements were performed before and after a 2 month dietary and lifestyle intervention wherein patients were counseled on the DASH diet and lifestyle program with a targeted 5% weight loss.
Results: There was a negative, linear relationship at baseline between the BMI and the abnormalities of nocturnal blood pressure patterns; the average BMI of the control group with a healthy dip in blood pressure nocturnally was 28.1 kg/m2, the average BMI of the group with a lack of nocturnal “dip” was 30.3 kg/m2 and the average BMI of the rise of nocturnal blood pressure group was 35.3 kg/m2 (p<0.0001, r=0.600). After the 2 month dietary intervention, we observed that individuals with abnormal baseline nocturnal blood pressure who achieved a weight loss of 5% or more had an average 8.4% dip in nocturnal blood pressure after the dietary intervention, representing a significant improvement in circadian blood pressure patterns. Those who did not achieve a 5% weight loss & those who gained weight had blood pressure that continued to show an aberrant circadian blood pressure pattern
Conclusions: The findings of this study suggest that obesity may be an important contributor to nocturnal BP abnormalities. Weight loss, through diet and lifestyle modifications, may improve nocturnal blood pressure pattern, restoring a healthy circadian blood pressure cycle.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Toward Precision Medicine in the Treatment of Elevated Blood Pressure
Abstract Category: 33. Prevention: Hypertension
Presentation Number: 1186-043
- 2017 American College of Cardiology Foundation