Association of blunted nighttime blood pressure dipping with coronary artery stenosis in men

Background: The aim of this work was to study the association between blunted nighttime dipping of blood pressure (BP) and coronary artery stenosis in men. Methods: Sixty-eight men (aged 52 +/- 11 years) with coronary artery disease (CAD) defined as greater than or equal to70% diameter stenosis. and a control group of 68 men, matched for age and risk factors without angiographic CAD were studied by ambulatory blood pressure monitoring. Patients were defined as nondippers when the nighttime systolic and diastolic BP decrease was <10%. Medications included beta-blockers in 20 (15%). calcium antagonists in 39 (29%), angiotensin-converting enzyme inhibitors in 44 (32%), angiotensin receptor blockers in 21 (15%), and diuretics in 37 (27%) patients. A logistic regression model was used to define independent predictors of angiographic CAD. Covariates were symptoms, total cholesterol, daytime BP, and nondipping. Results: A larger proportion of patients with CAD were nondippers as compared to control subjects (49 [72%] v 31 [46%], P < .005). In a logistic regression model, nondipping was associated with coronary artery stenosis independent of other clinical parameters (odds ratio 3.6, 95% confidence interval 1.6-8.8). Conclusions: Blunted nighttime dipping of BP is independently associated with angiographic coronary artery stenosis in men. (C) 2004 American Journal of Hypertension, Ltd.