Predictors of the development of masked nocturnal hypertension in treated patients of low and moderate cardiovascular risk

Abstract

Objective. To determine the predictors of the development of masked nocturnal hypertension (HTN) in treated patients of low and moderate cardiovascular risk (CVR). Design and methods. The study included 94 patients with treated HTN of low and moderate CVR without verified cardiovascular diseases. The median age was 42,24 ± 8,08 years. Patients were examined in accordance with the Clinical guidelines on HTN of the Russian Society of Cardiology, approved by the Ministry of Health of the Russian Federation (2020). Patients were divided into two groups depending on the presence or absence of masked nocturnal hypertension. The first group consisted of 54 (57,4 %) patients with masked nocturnal hypertension, the second group — 40 (42,6 %) patients with HTN and target indicators of office blood pressure (BP) and BP according to 24-hour BP monitoring. Results. A direct strong correlation between systolic BP at night and uric acid levels (r = 0,62, p < 0,001), a direct moderate relationship with the cardio-ankle-vascular index (CAVI1) (r = 0,31, p = 0,002), and an inverse moderate relationship with the concentration of high-density lipoprotein cholesterol (HDL cholesterol) (r = -0,47, p < 0,001) were found. When conducting logistic regression analysis and constructing a ROC-curve, the following predictors of the development of masked nocturnal HTN were established: an increase in uric acid > 389 μmol/l, a decrease in HDL < 1,49 mmol/l, an increase in the CAVI1 index > 6,9. Conclusions. In effectively treated patients with HTN with moderate and low CVR, the development of masked nocturnal HTN is associated with an increase in uric acid levels > 389 μmol/l, regardless of sex, an increase in the CAVI1 index > 6,9 and a decrease in HDL cholesterol levels < 1,49 mmol/l.