Association between non-dipper blood pressure pattern and coronary artery disease burden in hypertensive patients

BEKLER Ö., KURTUL A.

EXPERT REVIEW OF CARDIOVASCULAR THERAPY, vol.23, no.11, pp.753-760, 2025 (ESCI, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 23 Issue: 11
  • Publication Date: 2025
  • Doi Number: 10.1080/14779072.2025.2569399
  • Journal Name: EXPERT REVIEW OF CARDIOVASCULAR THERAPY
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus
  • Page Numbers: pp.753-760
  • Keywords: ABPM, ambulatory blood pressure monitoring, CAD, coronary artery disease, hypertension, Nocturnal hypertension, non-dipper blood pressure, SYNTAX score
  • Hatay Mustafa Kemal University Affiliated: Yes

Abstract

Background Non-dipper blood pressure (BP) patterns are associated with increased cardiovascular risk, but their relationship to coronary artery disease (CAD) complexity remains unclear. This study evaluated whether a non-dipper BP profile is linked to greater CAD burden in hypertensive patients using SYNTAX Scores (SS) I and II. Research design and methods A total of 381 hypertensive patients undergoing elective coronary angiography were prospectively enrolled. All underwent 24-hour ambulatory BP monitoring (ABPM) and were categorized as dipper or non-dipper. CAD burden was assessed using SS I and II. ROC analysis and multivariate logistic regression were performed. Results Non-dippers had significantly higher SS I (14.24 +/- 8.47 vs. 9.81 +/- 5.24) and SS II (28.64 +/- 9.64 vs. 22.30 +/- 6.57) than dippers (p < 0.001). SS II had greater predictive value (AUC: 0.704). Non-dipper status (OR: 20.1), diabetes, lower eGFR, and higher platelet count were independently associated with high SS, while age, gender, and high-sensitivity C-reactive protein (hs-CRP) were not. Conclusions Non-dipper BP was independently associated with greater anatomical and clinical CAD complexity. Integrating ABPM and SS may enhance cardiovascular risk stratification and inform individualized preventive strategies in hypertensive patients.