HIGH PREVALENCE OF NON-DIPPER AND REVERSE DIPPER PATTERN AMONG THE HUNGARIAN POPULATION ACCORDING TO THE NATIONWIDE ABPM REGISTRY

Objective: Current ESH guidelines recommend measuring night-time blood pressure (BP) using ABPM because it is more predictive for outcomes than daytime BP, and because nocturnal hypertension, non-dipping and reverse dipping, are associated with increased cardiovascular risk. The aim of our study was to assess the prevalence of different circadian patterns, and to determine the relevant comorbidities and risk factors according to the dipping status. Design and method: Data were collected from the Hungarian ABPM Registry, which is an ongoing, multicenter, open-label, observational study. Middle-aged cohort (55.94±15.1 years) patients (with female predominance (53.8%)) with known hypertension, or with suspected hypertension were involved in the study. Validated Meditech ABPM-06 was used. Current report analyzed 51428 ABPM data collected between 01.03.2021-30.06.2024. Results: After data cleaning, 47461 patients ABPM recordings were analyzed. 72% of all patients (n=34216) were on antihypertensive treatment. 10.5% (n=4992) of patients were reverse dippers (RDs), 42% (n=19967) non-dippers (NDs), 41.8% (n=19854) dippers (Ds), and 5.6% (n=2678) extreme dippers (EDs). RDs (63.39±14.24) and NDs (57.31±15.32) were older compared to Ds (53.12±14.42) and EDs (53.68±13.16) (p<0.001). RD and ND were more frequent in patients who received antihypertensive treatment, compared to untreated patients (RD: 12.4% (n=4256) vs. 5.5% (n=735); ND: 43.3% (n=14816) vs. 38.8% (n=5151); (p<0.001, Cramer’s V=0.13). Male sex, age, obesity, ischemic heart disease, cerebrovascular disease, diabetes mellitus, chronic kidney disease, peripheral artery disease, retinopathy increased the odds of reverse- and non-dipping status, while smoking and coffee consumption decreased, compared to dipping status. Predictors of extreme dipping pattern were smoking and coffee consumption. (See table)Conclusions: Reverse dipping and non-dipping pattern were highly prevalent in our cohort - regardless of antihypertensive treatment- which strongly associated with high cardiovascular risk. Thus, following hypertensive patients with ABPM seems to be necessary to identify and appropriately treat patients with higher cardiovascular risk.