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Morning blood pressure surge relates to autonomic neural activity in young non-dipping adults: The African-PREDICT study
Mokwatsi, G.G Schutte, A.E Mels, C.M.C Kruger, R
Mokwatsi, G.G
Schutte, A.E
Mels, C.M.C
Kruger, R
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Abstract
Background: It is well established that an exaggerated morning blood pressure surge (MBPS) is associated with an increased risk for cardiovascular disease development in hypertensive individuals. However, in non-dipping individuals, a lower surge was reportedly associated with increased cardiovascular risk. Sympathetic nervous system activity is involved in 24-hour blood pressure fluctuations, including night-time dipping and the MBPS. To better understand this interaction, we investigated associations of MBPS with heart-rate variability and baroreceptor sensitivity in young healthy dippers and non-dippers.
Methods: We included black and white men and women (n=827), aged 20-30 years and determined the MBPS using two formulas: the sleep-trough and dynamic morning surge. For autonomic function we determined baroreceptor sensitivity and heart-rate variability.
Results: The majority of non-dippers in this population were black (70.4%), presenting lower sleep-trough and dynamic morning surge (all p<0.001). Heart-rate variability was comparable between dippers and non-dippers, whereas baroreceptor sensitivity was higher in non-dippers (p=0.021). Despite a suppressed MBPS profile in non-dippers, we found both sleep-trough (β=-0.25; p=0.039) and dynamic morning surge (β=-0.14; p=0.047) to be inversely and independently associated with 24-hour heart-rate variability (total power). These results were absent in dippers.
Conclusions: In conclusion, we found a higher night-time blood pressure coupled with lower MBPS in young healthy non-dippers. Furthermore, this lower MBPS was independently and negatively associated with autonomic neural activity, suggesting increased autonomic function involvement in MBPS suppression of non-dippers. The predictive value of suppressed nocturnal dipping pattern should be investigated while taking autonomic neural activity into account.
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Date
2019-08
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Elsevier
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Keywords
Autonomic neural activity,Dippers,Morning blood pressure surge,Non-dippers
Citation
Mokwatsi GG, Schutte AE, Mels CMC, Kruger R. Morning Blood Pressure Surge Relates to Autonomic Neural Activity in Young Non-Dipping Adults: The African-PREDICT Study. Heart Lung Circ. 2019 Aug;28(8):1197-1205. doi: 10.1016/j.hlc.2018.07.003.