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<p>To investigate the association of different diurnal blood pressure patterns with heart rate variability (HRV) and hypertensive retinopathy (HR) risk in essential hypertension patients. A total of 181 patients (Jan 2023−Jun 2025) were grouped by nocturnal systolic blood pressure fall rate (SBPF): dipper (<i>n</i> = 57, 10%≤SBPF &lt; 20%), non-dipper (<i>n</i> = 62, 0 ≤ SBPF &lt; 10%), reverse-dipper (<i>n</i> = 62, SBPF &lt; 0%). Ambulatory blood pressure (BP), HRV indices, and HR detection rate were compared. Reverse-dipper had higher nocturnal SBP (nSBP), 24-hour SBP (24hSBP) than the other two groups (all <i>P</i> &lt; 0.05), and higher nocturnal DBP (nDBP) than dipper (<i>P</i> = 0.002). Dipper’s HRV indices (SDNN, SDANN, RMSSD, PNN50, LF, HF) were better than non-dipper (<i>P</i> &lt; 0.05); SDNN, SDANN, LF were better than reverse-dipper (all <i>P</i> &lt; 0.001). Reverse-dipper’s LF/HF was lower than others (<i>P</i> &lt; 0.05). HR detection rates: 3.5% (dipper), 46.8% (non-dipper), 50.0% (reverse-dipper) (<i>P</i> &lt; 0.001). Multivariable regression: BMI (OR = 1.131) was an independent risk factor; dipper (vs. reverse-dipper, OR = 0.031) was protective (<i>P</i> &lt; 0.05). Reverse-dipper has the highest nocturnal BP load, dipper the most favorable (better autonomic regulation). Ambulatory BP monitoring and BMI control are crucial to reduce target organ damage.</p>

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Association of diurnal blood pressure patterns with heart rate variability and retinopathy in patients with essential hypertension

  • 期刊论文

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  • 发表日期：

    2026年1月5日

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  • Fengping Gong,
  • Hui Li,
  • Tianfeng Huang,
  • Chen Gao

摘要

To investigate the association of different diurnal blood pressure patterns with heart rate variability (HRV) and hypertensive retinopathy (HR) risk in essential hypertension patients. A total of 181 patients (Jan 2023−Jun 2025) were grouped by nocturnal systolic blood pressure fall rate (SBPF): dipper (n = 57, 10%≤SBPF < 20%), non-dipper (n = 62, 0 ≤ SBPF < 10%), reverse-dipper (n = 62, SBPF < 0%). Ambulatory blood pressure (BP), HRV indices, and HR detection rate were compared. Reverse-dipper had higher nocturnal SBP (nSBP), 24-hour SBP (24hSBP) than the other two groups (all P < 0.05), and higher nocturnal DBP (nDBP) than dipper (P = 0.002). Dipper’s HRV indices (SDNN, SDANN, RMSSD, PNN50, LF, HF) were better than non-dipper (P < 0.05); SDNN, SDANN, LF were better than reverse-dipper (all P < 0.001). Reverse-dipper’s LF/HF was lower than others (P < 0.05). HR detection rates: 3.5% (dipper), 46.8% (non-dipper), 50.0% (reverse-dipper) (P < 0.001). Multivariable regression: BMI (OR = 1.131) was an independent risk factor; dipper (vs. reverse-dipper, OR = 0.031) was protective (P < 0.05). Reverse-dipper has the highest nocturnal BP load, dipper the most favorable (better autonomic regulation). Ambulatory BP monitoring and BMI control are crucial to reduce target organ damage.