Özet:

Background: The results of 24-hour ambulatory blood pressure, hypertension (HT), intra-day blood pressure (KB) variability, and 24-hour therapeutic efficacy were compared with clinical blood pressure (KB). In many normotensive or uncomplicated patients with HT, systolic (SKB) and diastolic KB (DKB) are reduced to the lowest levels during night sleep, reaching the highest value in the morning and showing a slow decrease during the day. Reduction of CB by more than 10% over daytime measurements shows that circadian changes occur. The presence of this daily change is defined as the dipper KB pattern which is a normal finding. Non-dipper BP was shown to be significantly associated with organ damage and deadly non-fatal cardiovascular disease (KVH). Numerous ACBI studies have been shown to be associated with non-dipper KB end organ damage and fatal and non-fatal cardiovascular (KV) events in normotensive individuals, not only in hypertensive patients. A systematic KV risk assessment is recommended for individuals with an increased risk of KV events. The SCORE risk system assesses the 10-year risk of the first lethal atherosclerotic event. The aim of this study was to investigate whether there is a relationship between non-dipper BP and SCORE risk system in normotensive individuals. Methods: In this study, 100 consecutive patients who were normotensive were evaluated prospectively. 52 of them were in normotensive non-dipper group and 48 were in normotensive dipper group. Non-dipper and dipper patient groups were determined according to ACB. According to the SCORE system, risk factors such as age, gender, smoking, systolic blood pressure (SKB), total cholesterol (TK) and HDL cholesterol were used to calculate the risk of 10-year fatal KV event. Results: SCORE risk system was significantly higher in the non-dipper normotensive study group (p = 0.005). LDL and TK values were significantly higher in non-dipper group. Creatinine clearance was higher in the dipper normotensive study group. Other demographic, clinical and laboratory parameters were similar between the two groups. In ACB, SKB and DKB were significantly higher in non-dipper normotensive study group at night (p <0.001). Although there was a moderate correlation between SCORE risk ratio and day to night SKB rate of change, there was a significant negative correlation and a negative but significant negative correlation with day and night DKB rate of change (r = 0.- 386, p <0.001; r = -0.294, p = 0.004). Conclusion: In this study, there was a significant relationship between non-dipper HT and SCORE risk system for the first time. The high probability of a 10-year fatal KV event calculated by the SCORE risk system in the non-dipper patient group revealed the importance of follow-up with ACB in normotensive individuals. In addition, non-dipper HT can be evaluated as an additional risk factor within the SCORE risk system. For this, long-term follow-up studies on prospective and more patients are needed.

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