Association Between Nondipper Behavior and Serum Calcium in Hypertensive Patients with Mild-to-Moderate Chronic Renal Dysfunction

• Published in: Clinical and experimental hypertension (1993) 2012-10, Vol.34 (6), p.417-423
• Main Authors: Feldstein, Carlos, Akopian, Maia, Olivieri, Antonio O., Garrido, Delia
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Blood Pressure Monitoring, Ambulatory; Calcium - blood; chronic kidney disease; Circadian Rhythm - physiology; Female; Humans; Hypertension - blood; Hypertension - complications; Hypertension - physiopathology; ionic calcium; Male; Middle Aged; NKF KDOQI; nondipping pattern; pulse pressure; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - physiopathology; Vascular Stiffness
• ISSN: 1064-1963; 1525-6006
• DOI: 10.3109/10641963.2012.665541

A nondipping BP pattern has been shown to be predictive of end-organ damage, cardiovascular events, and mortality. The mechanisms of blunted nocturnal BP fall are multifactorial. We assessed whether total corrected serum calcium and ionic calcium (iCa) are associated with a blunted nocturnal BP fall in both treated and untreated hypertensive patients with stages 1-3 of the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI). Clinical data and 24-hour ambulatory blood pressure monitoring were obtained in a cohort of 231 essential hypertensive patients. Among the entire cohort, 107 were nondippers and 124 were dippers. Only in nondippers, we found significant correlations between iCa and 24-hour systolic blood pressure (SBP; r = 0.21, P < .03), diurnal SBP (r = 0.21, P < .03), and 24-hour pulse pressure (PP; r = 0.23, P < .02). The ambulatory arterial stiffness index (AASI) was significantly related with 24-hour PP in both dippers and nondippers after adjusting for age. Both AASI and 24-hour PP were higher in nondippers than in dippers. In addition, in nondippers, the prevalence of estimated glomerular filtration rate (eGFR)