Evidence on the association of nondipping pattern with carotid atherosclerosis is scarce. We performed a meta-analysis in order to provide comprehensive information on subclinical carotid alterations in nondipping as compared with dipping individuals. A computerized search was performed using PubMed, OVID, EMBASE and Cochrane library databases from 1 January 1990 up to 31 March 2015. Full articles providing data on carotid intima-media thickness (IMT) and plaque in nondipping and dipping individuals, as assessed by ultrasonography, were analyzed. A total of 2753 adult individuals (1003 nondipping and 1750 dipping) included in 13 studies were considered. Common carotid IMT was higher in nondipping than in dipping individuals [807 +/- 36m vs. 746 +/- 28m, standard means difference, SMD: 0.37 +/- 0.09, confidence interval (CI): 0.19-0.56, P<0.01]. From data on plaque prevalence provided by five studies, the odds ratio for carotid plaques resulted 67% higher in nondipping (95% CI: 1.26-2.21, P<0.01) than in dipping individuals. Our findings support an association between nondipping pattern and increased risk of subclinical carotid alterations. In a practical perspective, the present meta-analysis reinforces the view that an effective blood pressure control over the entire 24-h period, in particular at night, may prevent the progression of vascular damage associated with nondipping phenotype.
Nondipping pattern and carotid atherosclerosis : a systematic review and meta-analysis / C. Cuspidi, C. Sala, M. Tadic, E. Gherbesi, G. Grassi, G. Mancia. - In: JOURNAL OF HYPERTENSION. - ISSN 1473-5598. - 34:3(2016 Mar), pp. 385-391. [10.1097/HJH.0000000000000812]
Nondipping pattern and carotid atherosclerosis : a systematic review and meta-analysis
C. Sala;E. Gherbesi;
2016
Abstract
Evidence on the association of nondipping pattern with carotid atherosclerosis is scarce. We performed a meta-analysis in order to provide comprehensive information on subclinical carotid alterations in nondipping as compared with dipping individuals. A computerized search was performed using PubMed, OVID, EMBASE and Cochrane library databases from 1 January 1990 up to 31 March 2015. Full articles providing data on carotid intima-media thickness (IMT) and plaque in nondipping and dipping individuals, as assessed by ultrasonography, were analyzed. A total of 2753 adult individuals (1003 nondipping and 1750 dipping) included in 13 studies were considered. Common carotid IMT was higher in nondipping than in dipping individuals [807 +/- 36m vs. 746 +/- 28m, standard means difference, SMD: 0.37 +/- 0.09, confidence interval (CI): 0.19-0.56, P<0.01]. From data on plaque prevalence provided by five studies, the odds ratio for carotid plaques resulted 67% higher in nondipping (95% CI: 1.26-2.21, P<0.01) than in dipping individuals. Our findings support an association between nondipping pattern and increased risk of subclinical carotid alterations. In a practical perspective, the present meta-analysis reinforces the view that an effective blood pressure control over the entire 24-h period, in particular at night, may prevent the progression of vascular damage associated with nondipping phenotype.File | Dimensione | Formato | |
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