Journals / Osmangazi Tıp Dergisi / 2026 / Cilt: 48 Sayı: 5

Effect of Total Water Percentage on Circadian Blood Pressure Variation in Prehypertensive Patients

Prehipertansif Hastalarda Toplam Vücut Suyu Yüzdesinin Sirkadiyen Kan Basıncı Değişimine Etkisi

Ahmet Cimbek(trabzon üniversitesi tıp fakültesi)0000-0003-4644-3045
Ahmet Özderya(Trabzon Üniveristesi Tıp Fakültesi)0000-0002-4369-6146
Pages
827–837
Publication Date
2026-08-26
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

These findings indicate that modifications in body fluid content may play a role in circadian blood pressure dysregulation and heightened cardiovascular risk.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Circadian changes in blood pressure are a key factor in determining cardiovascular risk.
📊
Key Findings & Data:A normal dipper pattern shows a decrease in blood pressure at night, whereas a non-dipper pattern shows a smaller decrease at night.
💡
Conclusion & Impact:These findings indicate that modifications in body fluid content may play a role in circadian blood pressure dysregulation and heightened cardiovascular risk.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Prehipertansiyon · Non-dipper hipertansiyon · Toplam vücut suyu

Abstract

Circadian changes in blood pressure are a key factor in determining cardiovascular risk. A normal dipper pattern shows a decrease in blood pressure at night, whereas a non-dipper pattern shows a smaller decrease at night. Changes in the distribution of bodily fluids may affect how blood vessels work and how blood pressure changes over the course of a day. This study aimed to examine the correlation between total body water percentage and circadian blood pressure patterns in individuals classified as prehypertensive. This retrospective cross-sectional study comprised 300 prehypertensive individuals who underwent 24-hour ambulatory blood pressure monitoring and body composition measurement via bioelectrical impedance. Patients were classified into two groups according to the magnitude of nocturnal blood pressure decline: dipper and non-dipper. Clinical, echocardiographic, and hydration characteristics were compared between the dipper and non-dipper groups. In the study population, 124 patients exhibited a dipper pattern, while 176 displayed a non-dipper pattern. Non-dipper patients exhibited a markedly reduced total body water percentage in comparison to dipper persons. Echocardiographic measures, such as interventricular septal thickness and left ventricular end-diastolic diameter, were markedly elevated in the non-dipper cohort. In multivariable logistic regression analysis, total body water percentage persisted as an independent predictor of non-dipper blood pressure pattern. A lower percentage of total body water is linked to a non-dipper blood pressure pattern in individuals who are prehypertensive. These findings indicate that modifications in body fluid content may play a role in circadian blood pressure dysregulation and heightened cardiovascular risk.

Özet

Kan basıncındaki sirkadiyen değişiklikler, kardiyovasküler riski belirlemede önemli bir faktördür. Normal bir "dipper" paterni, gece kan basıncında bir düşüş gösterirken, "non-dipper" paterni gece daha az bir düşüş gösterir. Vücut sıvılarının dağılımındaki değişiklikler, kan damarlarının nasıl çalıştığını ve kan basıncının gün boyunca nasıl değiştiğini etkileyebilir. Bu çalışma, prehipertansif olarak sınıflandırılan bireylerde toplam vücut suyu yüzdesi ile sirkadiyen kan basıncı paternleri arasındaki korelasyonu incelemeyi amaçlamıştır. Bu retrospektif kesitsel çalışma, 24 saatlik ambulatuvar kan basıncı izlemesi ve biyoelektrik empedans yoluyla vücut kompozisyonu ölçümü yapılan 300 prehipertansif bireyi içermiştir. Hastaları, gece kan basınçlarının ne kadar düştüğüne göre iki gruba ayırdık: dipper ve non-dipper. Gruplar arasındaki klinik, ekokardiyografik ve hidrasyon özelliklerindeki farklılıkları inceledik. Çalışma popülasyonunda 124 hasta dipper paterni gösterirken, 176 hasta non-dipper paterni göstermiştir. Kan basıncında gece düşüşü göstermeyen hastalarda, gece düşüşü gösteren kişilere kıyasla toplam vücut suyu yüzdesi belirgin şekilde azalmıştır. İnterventriküler septal kalınlık ve sol ventrikül diyastol sonu çapı gibi ekokardiyografik ölçümler, gece düşüşü göstermeyen grupta belirgin şekilde yüksek bulunmuştur. Çok değişkenli lojistik regresyon analizinde, toplam vücut suyu yüzdesi, gece düşüşü göstermeyen kan basıncı paterninin bağımsız bir belirleyicisi olarak kalmıştır. Daha düşük toplam vücut suyu yüzdesi, prehipertansif kişilerde gece düşüşü göstermeyen kan basıncı paterniyle ilişkilidir. Bu bulgular, vücut sıvı içeriğindeki değişikliklerin sirkadiyen kan basıncı düzensizliğinde ve artmış kardiyovasküler riskte rol oynayabileceğini göstermektedir.

🔖

Cite This Article

Cimbek, A., Özderya, A. (2026). Effect of Total Water Percentage on Circadian Blood Pressure Variation in Prehypertensive Patients. Osmangazi Tıp Dergisi, Cilt: 48 Sayı: 5, 827–837. https://doi.org/10.20515/otd.1911835

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (26)

  1. Goorani S, Zangene S, Imig JD. Hypertension: a continuing public healthcare issue. Int J Mol Sci. 2025;26(1):123.
  2. Casagrande M, Favieri F, Langher V, Guarino A, Di Pace E, Germanò G, et al. The night side of blood pressure: nocturnal blood pressure dipping and emotional dysregulation. Int J Environ Res Public Health. 2020;17(23):8892.
  3. Cuspidi C, Michev I, Meani S, Valerio C, Bertazzoli G, Magrini F, et al. Non-dipper treated hypertensive patients do not have increased cardiac structural alterations. Cardiovasc. Ultrasound. (2003);1(1).
  4. Routledge FS, McFetridge-Durdle JA, Dean CR, Canadian Hypertension Society. Night-time blood pressure patterns and target organ damage: a review. Can. J. Cardiol. (2007); 23(2): 132–138.
  5. Habas E, Akbar RA Sr, Alfitori G, Farfar KL, Habas E, Errayes N, et al. Effects of nondipping blood pressure changes: a nephrologist prospect. Cureus. 2023;15(7):e42681.
  6. Faraci FM, Scheer FAJL. Hypertension: causes and consequences of circadian rhythms in blood pressure. Circ Res. 2024;134(6):810-832.
  7. Nakagawa N, Sato N. Potential impact of non-dipping pulse rate pattern and nocturnal high pulse rate variability on target organ damage in patients with cardiovascular risk. Hypertens Res. (2023);46(4):1054–1055. https://doi.org/10.1038/s41440-023-01186-1
  8. Maniaci A, Lavalle S, Parisi FM, Barbanti M, Cocuzza S, Iannella G, et al. Impact of obstructive sleep apnea and sympathetic nervous system on cardiac health: a comprehensive review. J Cardiovasc Dev Dis. 2024;11(7):204.
  9. Parati G, Pengo MF, Avolio A, Azizi M, Bothe TL, Burnier M, et al. Nocturnal blood pressure: pathophysiology, measurement and clinical implications. Position paper of the European Society of Hypertension. J Hypertens. 2025;43(8):1296-1318.
  10. Mohammedin AS, AlSaid AH, Almalki AM, Alsaiari AR, Alghamdi FN, Jalalah AA, et al. Assessment of hydration status and blood pressure in a tertiary care hospital at Al-Khobar. Cureus. 2022;14(8):e27706.
  11. Watso JC, Farquhar WB. Hydration status and cardiovascular function. Nutrients. 2019;11(8):1866. doi:10.3390/nu11081866.
  12. Algül S, Özçelik O. Evaluation of effects of hydration and dehydration status on body composition analysis using bioelectrical impedance method. East J Med. 2022;27(2):258-263.
  13. Frąckiewicz J, Szewczyk K. Is there an association between hydration status, beverage consumption frequency, blood pressure, anthropometric characteristics, and urinary biomarkers in adults? Nutrients. 2025;17(6):952.
  14. Zhao L, Meng X, Zhang QY, Dong XQ, Zhou XL. A narrative review of prehypertension and the cardiovascular system: effects and potential pathogenic mechanisms. Ann Transl Med. 2021;9(2):170.
  15. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. (2014); 311(5): 507–520.
  16. McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension: Developed by the task force on the management of elevated blood pressure and hypertension of the European Society of Cardiology (ESC) and endorsed by the European Society of Endocrinology (ESE) and the European Stroke Organisation (ESO). Eur. Heart J. (2024); 45(38):3912-4018.
  17. Yano Y, Ning H, Muntner P, Reis JP, Calhoun DA, Viera AJ, et al. Nocturnal blood pressure in young adults and cognitive function in midlife: the CARDIA study. Am J Hypertens. 2015;28(10):1240-1247.
  18. O'Brien E, Sheridan J, O'Malley K. Dippers and non-dippers. Lancet. 1988;2(8607):397.
  19. Verdecchia P, Schillaci G, Guerrieri M, Gatteschi C, Benemio G, Boldrini F, et al. Circadian blood pressure changes and left ventricular hypertrophy in essential hypertension. Circulation. 1990;81(2):528-536.
  20. Portaluppi F, Montanari L, Massari M, Di Chiara V, Capanna M. Loss of nocturnal decline of blood pressure in hypertension due to chronic renal failure. Am J Hypertens. 1991;4(1 Pt 1):20-26.
  21. Ozdemir E, Yildirimturk O, Cengiz B, Yurdakul S, Aytekin S. Evaluation of carotid intima-media thickness and aortic elasticity in patients with nondipper hypertension. Echocardiography. 2014;31(5):663-668.
  22. Mahabala C, Kamath P, Bhaskaran U, Pai ND, Pai AU. Antihypertensive therapy: nocturnal dippers and nondippers. Do we treat them differently? Vasc Health Risk Manag. 2013;9:125-133.
  23. Sherwood A, Steffen PR, Blumenthal JA, Kuhn C, Hinderliter AL. Nighttime blood pressure dipping: the role of the sympathetic nervous system. Am J Hypertens. 2002;15(2 Pt 1):111-118.
  24. Sachdeva A, Weder AB. Nocturnal sodium excretion, blood pressure dipping, and sodium sensitivity. Hypertension. 2006;48(4):527-533.
  25. Lindroos M, Kupari M, Heikkilä J, Tilvis R. Predictors of left ventricular mass in old age: an echocardiographic, clinical and biochemical investigation of a random population sample. Eur Heart J. 1994;15(6):769-780.
  26. Huart J, Persu A, Lengelé JP, Krzesinski JM, Jouret F, Stergiou GS. Pathophysiology of the nondipping blood pressure pattern. Hypertension. 2023;80(4):719-729.