Clinical Implications of Nocturnal Blood Pressure Dipping Patterns in Hypertensive Patients in Libya: A 24-Hour Ambulatory Monitoring-Based Study

الملخص

Circadian variations in blood pressure, particularly nocturnal dipping patterns, have been identified as key determinants of
cardiovascular outcomes in hypertensive populations. This study investigates the prevalence of various dipping profiles and their
clinical significance among hypertensive patients in Tripoli, Libya.
This cross-sectional study involved 64 hypertensive adults at one of the cardiology private centers in Tripoli, Libya; who
underwent 24-hour ambulatory blood pressure monitoring (ABPM). Based on the percentage reduction in nighttime systolic
blood pressure, patients were categorized as dippers, non-dippers, reverse dippers, or extreme dippers. Clinical indicators,
including proteinuria and left ventricular hypertrophy (LVH), were assessed and compared across dipping groups.
Dipping abnormalities were identified in 61.7% of patients: non-dippers (30.8%), reverse dippers (19.2%), and extreme dippers
(11.7%). LVH was significantly more prevalent in non-dippers (50.0%) and reverse dippers (58.3%) compared to dippers
(20.8%) (P = 0.013). Similarly, the occurrence of proteinuria was higher among reverse dippers (41.7%) and non-dippers
(33.3%) compared to dippers (12.5%) (P = 0.021).
Conclusion: The high proportion of non-dipping and reverse-dipping patterns observed underscores the need for integrating
ABPM into hypertension management in Libya. These abnormal profiles were significantly associated with end-organ damage,
emphasizing their prognostic value.