Relation between nocturnal decline in blood pressure and choroidal thickness: a comparative analysis in dipper vs. non-dipper hypertensive patients

Abstract

Purpose To compare choroidal thickness (ChT) and echocardiographical changes in patients with dipper and non-dipper systemic arterial hypertension (HT). Methods Patients with HT were evaluated in two groups according to the 24-hour ambulatory BP monitoring. Compared to day-time values, those whose night-time SBP decreased ≥10% were defined as dippers, and those whose SBP decreased <10% were defined as non-dippers. Transthoracic echocardiography was conducted in all patients. ChT and central macular thickness were measured with spectral-domain optical coherence tomography. ChT was obtained at the subfoveal, 1500 µm nasal and temporal to the fovea. Results Thirty non-dipper (18 females and 12 males) and 23 dipper (16 females and seven males) hypertensive patients were recruited. Sex distribution and the mean age were similar between the groups (P = 0.472; P = 0.12). Disease duration was longer in the non-dipper group (8 ± 3.39 vs. 4.96 ± 1.19 years, P = 0.001). The non-dipper group had lower ChT in subfoveal and temporal locations (P = 0.02 and 0.03, respectively) and higher left atrial volume index (LAVI) and pulmonary valve maximum flow (PV-max; P < 0.001). The night-time SBP was negatively correlated with ChT (P = 0.048) and positive correlated with LAVI and PV-max (P < 0.05). However those correlations were not significant when were controlled by the possible confounding factors as disease duration, age and gender. Conclusion Non-dipper HT patients may have thinner choroid than dippers due to longer duration of HT and higher ambulatory BP levels.

Comparison of choroidal thickness and choroidal vascular index in normotensive dippers and nondippers

“…However, previous studies mainly focused on ChT in cardiovascular diseases or eye disorders 17,18 . Tas et al 10 reported that ChT in subfoveal and temporal locations were lower in the nondipper group, and they also found a negative correlation between night-time SBP and ChT. They focused on hypertensive patients with/without dipping patterns.…”

“…ChT in hypertensive patients with nondipper and dipper patterns and found significant differences among these patients 10 . As early identification of vascular changes in normotensive patients with nondipper status may have an impact on the prognosis of such patients, this study aimed to compare ChT and CVI changes in normotensive dippers and nondippers.…”