The combination of nondipper pulse rate pattern and nighttime high pulse rate variability is associated with an increase of brain natriuretic peptide: the J-HOP study.

The association between pulse rate (PR) and short-term PR variability and hypertensive organ damage has not been clarified. We enrolled 1439 patients from the J-HOP study. We calculated the standard deviation (SD) of PR in the nighttime using nighttime PR measurements at 30-min intervals. The SDs of PR (PR-SD) at nighttime were divided into quartiles (Q1-Q4). Nondipper PR was defined as (awake PR-sleep PR) < 0.1. Brain natriuretic peptide (BNP) levels were higher in patients with nondipper PR status in Q4 of PR-SD (nondipper PR/PR-SD Q4) than those with nondipper PR/PR-SD Q1-Q3 (37.8 vs 21.9 pg/mL, p = 0.041). The percentage of BNP > 100 pg/mL for patients with dipper PR/PR-SD Q1-Q3 was 5.2%, that for dipper PR/PR-SD Q4 was 4.8%, that for nondipper PR/PR-SD Q1-Q3 was 13.0%, and that for nondipper PR/PR-SD Q4 was 20.0% (ANOVA p < 0.001). In conclusion, BNP was high in patients having nondipper PR and high nocturnal PR-SD. Conceptual figure of subclinical heart failure and nondipper PR, PR variability. PR: pulse rate.