Korean Circ J.  2016 Nov;46(6):827-833. 10.4070/kcj.2016.46.6.827.

Endocan and Non-Dipping Circadian Pattern in Newly Diagnosed Essential Hypertension

• Cimen T
• Bilgin M
• Akyel A
• FelekoÄŸlu MA
• Nallbani A
• Ozdemir S
• Erden G
• Oztürk A
• DoÄŸan M
• Yeter E

• KMID: 2355459
• DOI: http://doi.org/10.4070/kcj.2016.46.6.827

Abstract

BACKGROUND AND OBJECTIVES
Non-dipper hypertension is frequently accompanied by endothelial dysfunction and activation. Previous studies suggested that endocan may be a novel endothelial dysfunction marker. This study aims to investigate the association between circadian blood pressure (BP) pattern and plasma endocan levels together with high-sensitivity C-reactive protein (hsCRP) in patients with newly diagnosed untreated hypertension.
SUBJECTS AND METHODS
Twenty-four hour ambulatory blood pressure monitoring was recorded in 35 dipper, 35 non-dipper hypertensives and 35 healthy controls. Endocan levels were measured by enzyme-linked immunosorbent assay. Serum levels of hsCRP were also recorded.
RESULTS
Despite similar daytime and 24-hour average BP values between dippers and non-dippers, statistically significant high nocturnal BP was accompanied by a non-dipping pattern (Systolic BP: 132±9 vs. 147±11 mmHg; Distolic BP: 80±7 vs. 91±9 mmHg, respectively, p<0.001 for both). Non-dipper patients demonstrated higher endocan levels compared to dippers and normotensives (367 (193-844) pg/mL, 254 (182-512) pg/mL and 237 (141-314) pg/ml, respectively, p<0.001). HsCRP levels were significantly higher in non-dippers than the other groups (p=0.013). In a multivariate logistic regression analysis, endocan (p=0.021) and hsCRP (p=0.044) were independently associated with a non-dipping pattern.
CONCLUSION
Elevated endocan levels were found in non-dipper groups. Endocan and hsCRP were found to be independently associated with a non-dipping pattern. We suggest that elevated levels of endocan in non-dipper hypertensive patients might be associated with a longer duration of exposure to high BP. These results point to the possible future role of endocan in selection of hypertensive patients at higher risk or target organ damage.

Keyword

Blood pressure monitoring, ambulatory; Hypertension; Dipping pattern; Endocan

MeSH Terms

Blood Pressure
Blood Pressure Monitoring, Ambulatory
C-Reactive Protein
Enzyme-Linked Immunosorbent Assay
Humans
Hypertension*
Logistic Models
Plasma
C-Reactive Protein

Figure

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  Fig. 1 Comparison of endocan levels in non-dippers compared with dippers and controls . NS: non-significant.

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  Fig. 2 Comparison of hsCRP levels in non-dippers compared with dippers and controls. NS: non-significant, Hs-CRP: high-sensitivity C-reactive protein.

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  Fig. 3 Receiver operating characteristic curve of endocan for predicting non-dipper hypertension.

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