[PP.29.20] CIRCADIAN BLOOD PRESSURE PATTERN AND METABOLIC SYNDROME

Objective: The metabolic syndrome (MS) is associated with a 2-fold increase in cardiovascular outcomes and a 1.5-fold increase in all-cause mortality. On the other hand, impaired nocturnal blood pressure decline associates to higher incidence on stroke, chronic kidney disease, and other cardiovascular diseases when compares to patients with normal dipper pattern. The aim of this study was to assess the five criteria distribution of MS according to circadian BP pattern. Design and method: A cross sectional study was conducted among 514 hypertensive subjects and MS (age: 53.3 years; 52,7% male. BP was measured by ambulatory monitoring (ABPM) every 20 min between 07:00 am and 23:00 pm and every 30 min at night, along 48 hours with a Spacelabs 90207 device. We analyzed 48h-systolic and 48h-dyastolic mean ambulatory blood pressure (48h-SBP and 48h-DBP), 48 h nocturnal systolic and diastolic blood pressure falling. Clinical and biological assessments were performed in all subjects. Results: The overall prevalence rates of circadian BP pattern were as follows: 9.7% riser; 34.4% no dipper, 48.4% with normal BP falling and only 7.4% with very dipper pattern. There were no significant differences between groups regarding systolic BP, weight or BMI but on waist circumference (103.4 Vs 100.4 Vs 98.6 Vs 101.2 cms, respectively). When analyzing different criteria of MS we only found differences when comparing diastolic BP (77.2 Vs 84.7 Vs 86.0 Vs 86.9 mmHg, respectively) or fasting glucose (121.9 Vs 111.6 Vs 107.1 Vs 113.8 mmHg). Neither fasting trygliceride nor HDL cholesterol showed differences. Waist circumference and fasting glucose poorly and inversely correlated with systolic blood pressure falling (r: -0.154; p = 0.001 and r: -0.151; p = 0.001) and dyastolic BP falling (r: -0.166; p = 0.000 and r: -0.198; p = 0.000). Conclusions: In our cohort abnormal circadian BP pattern (“riser”, “non dipper” and “very dipper”) associate with higher waist circumference as well as higher fasting glucose levels These results may help us to understand the underlying process of increased cardiovascular risk in hypertensive subjects with impaired nocturnal BP falling.