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Non-dipping nocturnal blood pressure in psoriasis vulgaris

Fehlendes Dipping des nächtlichen Blutdrucks bei Psoriasis vulgaris

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Summary

Background

Psoriasis vulgaris is one of the most prevalent chronic, inflammatory skin disorders. Patients with psoriasis carry an excess risk of hypertension and adverse cardiovascular (CV) events. Blood pressure (BP) has a circadian rhythm characterised with lower values at night. A blunted nocturnal BP decline defined as non-dipping accelerates the development of hypertension and CV diseases. The aim of this study is to evaluate circadian variation of blood pressure in normotensive middle-aged patients with psoriasis vulgaris.

Methods

Seventy adult patients with psoriasis vulgaris (group 1) and 70 age and sex-matched healthy individuals (group 2) were included in the study. Ambulatory BP monitoring was performed in all participants over a 24-h period. Non-dippers are defined as those who show a reduction in BP of less than 10 % between the average day and night systolic BP.

Results

Although mean 24-h BPs were similar in both groups, night-time BPs were significantly higher in psoriatic patients (115.1 ± 7.7 vs. 109.9 ± 6.0 mmHg and 72.1 ± 7.0 vs. 67.6 ± 5.5 mmHg, respectively; p < 0.05). The non-dipping pattern of BP changes was significantly more common in patients with psoriasis vulgaris compared with the control group (65.9 vs. 34.1 %, p < 0.01). Psoriasis severity and BMI are independent predictors of impaired nocturnal BP regulation.

Conclusions

Patients with psoriasis vulgaris had increased nocturnal BP and heart rate. This is the first study to demonstrate a blunted nocturnal BP decrease in normotensive patients with psoriasis.

Zusammenfassung

Grundlagen

Psoriasis vulgaris ist eine der häufigsten chronischen entzündlichen Hauterkrankungen. Patienten mit Psoriasis haben ein erhöhtes Risiko einer Hypertonie und kardiovaskulärer Ereignisse. Der Blutdruck (RR) hat normaler Weise einen zirkadianen Rhythmus, charakterisiert durch niedrigere Werte während der Nacht. Ein Fehlen dieses Abfalls des RRs („Non-Dipping“) beschleunigt die Entwicklung einer Hypertonie und kardiovaskulärer Erkrankungen. Ziel dieser Studie ist es, den zirkadianen Rhythmus des RRs bei normotensiven Patienten mittleren Alters mit Psoriasis vulgaris zu evaluieren.

Methodik

Siebzig erwachsene Patienten mit Psoriasis vulgaris (= Gruppe 1) und 70 alters-und geschlechts-gematchte gesunde Personen (= Gruppe 2) wurden in die Studie aufgenommen. Bei allen Teilnehmern an der Studie wurde ein ambulantes 24-h RR Monitoring durchgeführt. „Non-Dippers“ wurden definiert als jene, die weniger als 10 % Abfall des systolischen RRs nachts – im Vergleich zum mittleren systolischen RR während des Tages aufwiesen.

Ergebnisse

Obwohl die mittleren 24 h RR Werte in beiden Gruppen ähnlich waren, waren die nächtlichen RR Werte bei den Psoriasis Patienten signifikant höher (115,1 ± 7,7 vs. 109,9 ± 6,0 mmHg und 72,1 ± 7,0 vs. 67,6 ± 5,5 mmHg, respektive; p < 0,05). Das „Non-Dipping“ Muster der RR Veränderungen war bei Psoriasis vulgaris signifikant häufiger als in der Kontrollgruppe (65,9 vs. 34,1 %, p < 0,01). Der Schweregrad der Psoriasis und der BMI waren unabhängige Prädiktoren einer gestörten nächtlichen RR Regulation.

Schlussfolgerungen

Patienten mit Psoriasis vulgaris hatten erhöhte nächtliche RR Werte und Herzfrequenz. Dies ist die 1. Studie, die ein Fehlen des nächtlichen RR Abfalls bei normotensiven Psoriasis Patienten zeigt.

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Conflict of interest

The authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Cardiology, Faculty of Medicine, BezmiÂlem Foundation University, Vatan Street, 34093, Fatih/Istanbul, Turkey

    Ahmet Bacaksiz MD, Mehmet Akif Vatankulu MD, Osman Sonmez MD, Ercan Erdogan MD, Abdurrahman Tasal MD, Murat Turfan MD, Gokhan Ertas MD & Emrah Sevgili MD

  2. Department of Dermatology, Faculty of Medicine, BezmiÂlem Foundation University, Istanbul, Turkey

    Didem Dizman MD &  Nahide Onsun

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  1. Ahmet Bacaksiz MD
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  2. Mehmet Akif Vatankulu MD
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Correspondence to Ahmet Bacaksiz MD.

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Bacaksiz, A., Akif Vatankulu, M., Sonmez, O. et al. Non-dipping nocturnal blood pressure in psoriasis vulgaris. Wien Klin Wochenschr 124, 822–829 (2012). https://doi.org/10.1007/s00508-012-0294-y

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