Circadian rhythm and blood pressure in patients with ambulatory blood pressure monitoring and its relationship with the risk of cardiovascular events

Introduction: Cardiovascular diseases are the group of diseases that cause most deaths world-wide, being arterial hypertension the modifiable risk factor that mostly predisposes to other cardiovascular diseases development. In this regard, ambulatory blood pressure monitoring (ABPM) lets to detect the different changes in blood pressure throughout 24 h, known as cir-cadian patterns (dipper, non-dipper, riser or extreme dipper). There may be an association between these patterns and cardiovascular risk, so this study aims to compare cardiovascu-lar risk using the 2 validated scales REGICOR and SCORE in patients with different circadian patterns using ABMP.Material and methods: Retrospective study of hypertensive patients with ABMP registered bet-ween 2015 and 2021 in Alcazar de San Juan and Madridejos. Data were collected from clinical history (arterial hypertension, BMI, comorbidities, and smoking habits) and ABPM records, as well as sociodemographic and analytical variables, cardiovascular risk scales (REGICOR and SCORE) and circadian rhythm variables (dipper, extreme dipper, non-dipper and rise pattern).Results: Two hundred and sixty-nine patients (46.5% female, 64.3 +/- 12.6 years old) were inclu-ded. There were 38.3% with dipper pattern, 10% extreme dipper, 33.1% non-dipper and 18.6% riser. Patients with riser pattern showed higher score on the REGICOR and SCORE scales (34 and 68%, respectively). A significant correlation was established between both scales (Spearman rho: 0.589; p < 0.001), but with poor concordance (kappa = 0.348 [95% CI 0.271-0.425]).Conclusion: ABMP has turned into a very useful tool in the diagnosis and treatment of arterial hypertension. In addition, the circadian patterns of these patients may correlate to the choice of an adequate treatment and correct follow-up.(c) 2023 Sociedad Espanola de Medicos de Atenci ' on Primaria (SEMERGEN). Published by Elsevier Espana, S.L.U. All rights reserved.