Nocturnal blood pressure is associated with sympathetic nerve activity in patients with chronic kidney disease

• Published in: Physiological reports 2020-10, Vol.8 (20), p.e14602-n/a
• Main Authors: Jeong, Jin H., Fonkoue, Ida T., Quyyumi, Arshed A., DaCosta, Dana, Park, Jeanie
• Format: Article
• Language: English
• Subjects: Adrenergic receptors; Bioavailability; Bioengineering; Blood Pressure; Brachial Artery - physiopathology; Cardiac stress tests; Chronic Kidney Disease; Coronary vessels; Creatinine; Daytime; Diurnal; Endothelial Dysfunction; Endothelium; Endothelium, Vascular - physiopathology; Female; Heart; Humans; Hypertension; Kidney diseases; Male; Medical prognosis; Middle Aged; Mortality; Nervous system; Nighttime; Nocturnal; Nocturnal Blood Pressure; Original; Photoperiod; Physiology; Renal Insufficiency, Chronic - physiopathology; Sympathetic nerves; Sympathetic Nervous System; Sympathetic Nervous System - physiopathology; Veins & arteries
• ISSN: 2051-817X
• DOI: 10.14814/phy2.14602

Elevated nocturnal blood pressure (BP) and nocturnal non‐dipping are frequently observed in patients with chronic kidney disease (CKD) and are stronger predictors of cardiovascular complications and CKD progression than standard office BP. The sympathetic nervous system (SNS) is thought to modulate diurnal hemodynamic changes and the vascular endothelium plays a fundamental role in BP regulation. We hypothesized that SNS overactivity and endothelial dysfunction in CKD are linked to elevated nocturnal BP and non‐dipping. In 32 CKD patients with hypertension (56 ± 7 years), office BP, 24‐hr ambulatory BP, muscle sympathetic nerve activity (MSNA) and endothelial function via flow‐mediated dilation (FMD) were measured. Participants were subsequently divided into dippers (nighttime average BP > 10% lower than the daytime average BP, n = 8) and non‐dippers (n = 24). Non‐dippers had higher nighttime BP (p