The Relation Between Non-dipping Blood Pressure Pattern and Postural Orthostatic Tachycardia Syndrome in Hypertensive Patients

Abstract

AABBSSTTRRAACCTT OObbjjeeccttiivvee:: Postural orthostatic tachycardia syndrome (POTS) is an orthostatic intoler- ance with a pathophysiology that is likely to be heterogeneous. Hypertensive patients with a non-dipping pattern have an increased cardiovascular risk. There is a possibility that the same pathophysiological mechanisms may have a role in both POTS and the non-dipping pattern. To our knowledge, there are some studies showing the relation between POTS and non-dipping pattern in normotensive patients. However, data about this relation in hypertensive patients is limited. Our aim was to investigate the relation between 24-hour ambulatory blood pressure monitoring (ABPM) parameters and POTS in our study. MMaatteerriiaall aanndd MMeetthhooddss:: A total of 271 suitable patients were enrolled in our study. ABPM, Tilt table test, echocardiography, and labo- ratory tests were performed. RReessuullttss:: The study included 39 (14.3%) patients with POTS. There were no differences in the demographic variables, drug therapies, and laboratory as well as echocar- diography parameters in all patients. Day-time, night-time, and 24-hour mean systolic and diastolic blood pressures and frequency of non-dipping pattern were significantly higher in patients with POTS. Day-time mean systolic blood pressure and non-dipping pattern were determined as independent predictors for POTS in multivariate logistic regression analysis. CCoonncclluussiioonn:: A relation was observed between POTS and non-dipping pattern in patients with hypertension, which needs further exploration in larger and detailed studies. Clinicians might be aware of POTS if their hypertensive patients complain of palpitations, lightheadedness, and fatigue in an upright position.