Diego I. Vanegas-Cadavid, Departamento de Cardiología, Hospital Militar Central; Fundarritmia-Fundación Cardiovascular. Bogotá, Colombia
Andrés F. Blanco-Ruiz, Fundarritmia-Fundación Cardiovascular, Bogotá, Colombia
Linda Ibatá, Fundarritmia-Fundación Cardiovascular, Bogotá, Colombia
Introduction: Despite debate over definitions, patterns like reverse-dipper (RDP) phenotypes are determined solely by the nightto- day mean systolic blood pressure (mSBP) ratio, without considering variations in nighttime SBP load and hyperbaric impact (HBI). Objective: To describe the potential spectrum of RDP phenotypes. Materials and method: This was a cross-sectional observational study of adults diagnosed with an RDP using 24-hour ambulatory blood pressure monitoring (ABPM). Clinical information was extracted from electronic medical records and ABPM. The systolic hyperbaric impact (SHBI) at night, nighttime mSBP/daytime mSBP ratio, isolated nocturnal hypertension (INHTN), and sustained hypertension (SHTN) (day and night) were recorded. Results: A total of 136 RDP patients were included. Three subgroups were identified based on ratio, SBP load, day/ night mSBP difference, SHTN, INHTN, and SHBI. These subgroups showed different ABPM values, characterizing distinct phenotypes with statistical significance. Conclusion: This study revealed diverse phenotypes within RDP, marked by a varying SBP load and HBI at night, alongside day-night SBP gradients and the presence or absence of INHTN/SHTN. These subtypes may exhibit different clinical behaviours and prognoses, offering a fresh perspective on RDP classification.
Keywords: Hypertension. Ambulatory blood pressure monitoring. Reverse dipper.
