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. 2025 Aug;73(8):25-30.
doi: 10.59556/japi.73.1067.

Circadian Blood Pressure Profile and Associated Cardiovascular Risk Factors in Prehypertensive Patients and Its Relationship with Urinary Albumin-to-Creatinine Ratio

Jaldu Krishna Pavan  1 , Ashok Kumar  2 , Gutti Prasanth  1 , Shubha Laxmi Margekar  3 , Shivani Bansal  4
Affiliations

Circadian Blood Pressure Profile and Associated Cardiovascular Risk Factors in Prehypertensive Patients and Its Relationship with Urinary Albumin-to-Creatinine Ratio

Jaldu Krishna Pavan et al. J Assoc Physicians India. 2025 Aug.

Abstract

Background: Prehypertension is characterized by a systolic blood pressure (SBP) ranging from 120 to 139 mm Hg and a diastolic blood pressure (DBP) between 80 and 89 mm Hg, acting as a precursor to hypertension and potentially increasing cardiovascular risks. This study investigates the circadian patterns of blood pressure (BP), dipper status, and associated cardiovascular risk factors in prehypertensive individuals, with a particular focus on the relationship with the urinary albumin-to-creatinine ratio (UACR) as a marker of kidney and vascular health.

Objective: To assess the circadian rhythm of BP in prehypertensive patients and examine its relationship with UACR and other cardiovascular risk factors.

Methods: In this research involving systematic observation, a total of 101 participants were included, 57.4% of whom were identified as prehypertensive. Prehypertensive participants were grouped into "dippers" or "nondippers" based on a nocturnal BP reduction threshold of greater than or <10%, respectively. UACR, high-sensitivity C-reactive protein (Hs-CRP), lipid profiles, and additional biochemical parameters were measured. Statistical analysis included t-tests and analysis of variance (ANOVA) were utilized to examine associations.

Results: Prehypertensive subjects demonstrated significantly higher mean 24-hour SBP and DBP than normotensive controls (p < 0.001). Dipper status was identified in 55.2% of prehypertensives, with nondippers exhibiting elevated nighttime SBP and DBP (p < 0.001). UACR and nondipper status were found to be significantly correlated (p = 0.034), with nondippers also displaying elevated Hs-CRP levels, indicating greater systemic inflammation.

Conclusion: Circadian BP variability and dipper status in prehypertensive patients correlate with UACR and Hs-CRP levels, suggesting that nondippers may be at increased cardiovascular risk. Ambulatory blood pressure monitoring (ABPM) offers valuable insights into early hypertension risk and can aid in identifying prehypertensive individuals requiring closer monitoring and intervention.

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