Evalution of the effect of 24-hour ambulatory blood pressure measurement on blood pressure variability in obese and non-obese hypertensive patients

Objective: The aim of our study is to compare the blood pressure variability parameters using the method of 24-hour ambulatory blood pressure measurement in obese and non obese, stage 1 or stage 2 hypertensive patient groups. Additionally, we investigate whether blood pressure variability is higher in obese patients and examine the effect of anti hypertensive treatment on blood pressure variability. Method: One hundred obese and fifty non-obese patients, previously diagnosed with hypertension and either receiving or not receiving antihypertensive treatment, or newly diagnosed with hypertension, were selected from patients attending the Nephrology and Cardiology outpatient clinics. Demographic data, heigt and weight measurement, laboratory parameters, comorbidities, resting blood pressure measurement values, blood pressure variability parameters calculated by 24-hour ambulatory blood pressure measurement, and mean blood pressure measurement values were recorded. The number of patients with a non-dipper pattern in both groups was determined. SPSS version 18.0 was used for statistical analysis. Results were evaluated at a significance level of p < 0.05 with a 95% confidence interval. Results: In our study, the age distribution and the number of diabetic patientes were similar in all three groups (p=0.623 and p =0.986). There was no statistically significant difference in the distribution of biochemical parameters between non-obese and obese patient groups ( p>0.05 ) .The distribution of average systolic blood pressure measurement values within patient groups was statistically different (p=0.015). The distribution of average diastolic blood pressure measurement values within patient groups was statistically different (p=0.032). When comparing groups in terms of blood pressure variability parameters, the highest blood pressure variablitiy was found in the Stage 2 obese group, and the lowest in the Non-obese group. Regarding systolic blood pressure variability;SD24 systolic blood pressure variablitiy was 19.33±4.39 mm/Hg in the Stage 2 obese group, 18.32±4.08 mm/Hg in the Stage 1 obese group, and 14.11±3.28 mm/Hg in the Non-obese group (p<0,01 ;p<0,01;p<0,01). SDd systolic blood pressure variability was 22.75±5.20 vii mm/Hg in the Stage 2 obese group, 17.85±4.83 mm/Hg in the Stage 1 obese group, and 13.45±3.69 mm/Hg in the Non-obese group (p<0.01 ;p<0.01;p<0.01 ), and ARV24 systolic blood pressure variability was15.40±3.72 mm/Hg in the Stage 2 obese group, 12.86 ± 3.86 mm/Hg in the Stage 1 obese group, and 8.99±2.82 mm/Hg in the Non-obese group (p<0,.01 ;p<0.01;p<0.01 ), and the differences were statistically significant. In terms of diastolic blood pressure variability; SD24 diastolic blood pressure variability was 13.51 ± 2.97 mm/Hg in the Stage 2 obese group, 12.95±2.59 mm/Hg in the Stage 1 obese group and 10.84±2.70 mm/Hg in the Non-obese group (p<0.01;p<0.01;p<0.01 ), SDd diastolic blood pressure variability was 14.74±3.73 mm/Hg in the Stage 2 obese group, 12.34±2.75 mm/Hg in the Stage 1 obese group, and 10.13±2.64 mm/Hg in the Non-obese group (p<0.01; p<0.01 and p=0.033) and ARV24 diastolic blood pressure variability was 9.97± 3.23 mm/Hg in the Stage 2 obese group,9.09±2.54 mm/Hg in the Stage 1 obese group, and 6.58±1.93 mm/Hg in the Non-obese group (p<0.01;p<0.01;p<0.01 ). The use of calcium channel blockers and renin-angiotensin-aldosterone inhibitors was found to be similar in the obese and non-obese groups (p=0.561 and p=0.486 ). Both in the obese and non-obese groups, the use of calcium channel blockers resulted in a decrease in all blood pressure variability parameters. Modarete correlation was found between ARV24 systolic blood pressure variability and weight (r=0,553 and p<0.01), good correlation between BMI and ARV24 systolic blood pressure variability (r=0.608 and p<0.01),and low correlation between average systolic blood pressure and ARV24 systolic blood pressure variability (r=0.28 an p<0.01). No difference was found between groups in terms of the number of non-dipper patients (p=0.792). Conclusion: In our study, including Stage 1 and Stage 2 hypertensive patients, all blood pressure variability parameters were found to be higher in the Stage 1 and Stage 2 obese group compared to the Non-obese group. The use of calcium channel blockers resulted in lower blood pressure variability in both obese and non-obese patients. As blood pressure variability increases, an increase in morbidity and mortality associated with hypertension is observed. Control of hypertension with medical treatment in both obese and hypertensive patients, consideration of calcium channel blocker use in medical treatment, and ensuring weight loss through lifestyle changes in patients are essential.