Nighttime hypertension tied to asymptomatic organ damage in young individuals

Both nocturnal hypertension and nondipping are predictive of asymptomatic hypertension-mediated organ damage (HMOD) in young individuals, but nighttime blood pressure (BP) levels appear to be the main contributing factor, suggests a study.

A total of 276 individuals (mean age 13.8 years, 67 percent males) with 24-h ambulatory BP monitoring (ABPM) data (23.6 percent ABPM hypertension, 26.4 percent nighttime hypertension, and 30.4 percent nondippers) and left ventricular mass index (LVMI; n=257) and/or intima-media thickness (IMT; n=205) were included in this analysis.

Indices of HMOD and BP increased with age, while nondipping prevalence showed no association with age. Compared with dippers, nondippers had higher LVMI (30.5 vs 28.4 g/m^2.7; p=0.01) and IMT (0.52 vs 0.50 mm; p=0.02), adjusted for age, sex BMI z-score (BMIz), and 24-h systolic BP (SBP).

Furthermore, individuals with nighttime hypertension had higher LVMI (32.76 vs 27.69 g/m^2.7; p<0.001) and showed a trend towards higher IMT (0.52 vs 0.50 mm; p=0.16) than those with nighttime normotension, adjusted for age, sex, and BMIz. Similarly, LVMI was higher in dippers and nondippers with nighttime hypertension than in dippers with nighttime normotension (p<0.05 for all).

Multivariable analysis revealed the independent association of nondipping with LVMI/IMT (β, ‒2.14/‒0.02; p<0.05 for all), after adjustment for 24-h SBP, but not for nighttime SBP (β, ‒0.09/‒0.01; p=NS for all).

In this study, the authors assessed individuals aged 6‒25 years with 24-h ABPM. HMOD analysis involved LVMI and ultrasonographic common carotid artery IMT.