Urinary albumin excretion among nondipper hypertensive patients is closely related with the pattern of nondipping

The relationship between 24-hour urinary albumin excretion (UAE) rate and the pattern of nondipping (isolated systolic nondipping, isolated diastolic nondipping, and both systolic and diastolic nondipping) is not known. Medical history, physical examination, laboratory analysis, and office and ambulatory blood pressure measurements were performed. Twenty-four hour urine specimens were collected to determine creatinine clearance and UAE. In total, 158 essential hypertensive patients (104 dippers, 54 nondippers) were included. Fourteen patients were isolated systolic nondippers, 7 patients were isolated diastolic nondippers, and 33 patients were both systolic and diastolic nondippers. Among nondipper patients, 17 had microalbuminuria and, among dipper patients, 9 had microalbuminuria (P < .0001). The median UAE of dippers was lower when compared with nondippers (5.25 mg/day vs.23 mg/day, P < .0001). The median UAE of isolated systolic nondippers, isolated diastolic nondippers, and both systolic and diastolic nondippers were 8.45 mg/day, 7.7 mg/day, and 25.5 mg/day, respectively (P = .001). Subgroup comparison of patients revealed that UAE was higher in patients with both systolic and diastolic nondippers when compared with dippers (P < .0001), isolated systolic nondippers (P = .001), and isolated diastolic nondippers (P = .017). Not only nondipping itself, but nondipping profile may be related with UAE in essential hypertensive patients. J Am Soc Hypertens 2010;4(4):196-202. (C) 2010 American Society of Hypertension. All rights reserved.