Correlation between circadian rhythm of blood pressure and carotid atherosclerosis in patients with essential hypertension:a Meta-analysis
Qin Zelin
Duan Wenhui
Chen Jinliang
Chen Haokun
Li Ruoqi
Bai Yanjun
Abstract：Objective To discuss the correlation between circadian rhythm of blood pressure(BP)and carotid atherosclerosis(CAS)by applying Meta-analysis.Methods The databases of PubMed,Web of Science,EMbase,Cochrane Library,CNKI,WanFang Data and VIP were retrieved from database establishment time to Jan.1,2024 for searching the observational studies on correlation between BP circadian rhythm and CAS in patients with essential hypertension(EH).The risk of bias was reviewed by using Newcastle-Ottawa Scale(NOS)or tool for assessing risk of bias of Agency for Healthcare Research and Quality(AHRQ).A Meta-analysis was conducted by using Stata 17 software.Results There were totally 28 studies with moderate or high quality from 6 countries.CAS indexes included carotid artery intima-media thickness(CA-IMT),carotid artery plaques and high sensitivity C-reactive protein(hs-CRP).The results of Meta-analysis showed that non-dipper BP circadian rhythm was possibly the risk factor for increases of CA-IMT(MD=0.13,95%CI:0.08～0.18,P＜0.0001),detection rate of carotid artery plaques(OR=1.60,95%CI:1.20～2.13,P=0.001＜0.05)and hs-CRP(MD=1.47,95%CI:0.52～2.41,P=0.002)compared with normal dipper BP circadian rhythm.The hyper-dipper BP circadian rhythm was possibly a risk factor for CA-IMT increase(MD=0.14,95%CI:0.13～0.15,P＜0.0001).The reverse-dipper BP circadian rhythm was risk factors possibly for increases of CA-IMT(MD=0.32,95%CI:0.28～0.37,P＜0.0001)and detection rate of carotid artery plaques(OR=2.82,95%CI:1.42～5.60,P＜0.0001).The results of subgroup analysis showed that CA-IMT was higher in Asia than that in rest of world,female patients increased more significantly,and CA-IMT and hs-CRP increased more significantly patients aged over 60 in non-dipper BP circadian rhythm group.Conclusion Abnormal blood pressure rhythm is a risk factor for CAS and is independent of blood pressure level.It is important to maintain normal blood pressure rhythm for relieving target organ damage and preventing cardiovascular events.
Keywords：Essential hypertensionBlood pressure rhythmCircadian rhythmCarotid atherosclerosisMeta-analysis
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 385-391,395 )