Relationship Between Monocyte/HDL Cholesterol Ratio and Urinary Protein Excretion in Patients with Primary Hypertension with Reverse Dipper Pattern

Objective: Ambulatory blood pressure (BP) monitoring is confronted with different clinical patterns due to diurnal changes. Rise of BP at night is known as reverse dipper, whereas it is expected to decrease at night physiologically. The monocyte/high-density lipoprotein (HDL) cholesterol ratio (MHR) is considered as a marker of inflammation and oxidative stress. The aim of the present study was to investigate the relationship between MHR and urinary protein excretion in a reverse dipper hypertension (RDHT) patient group.

Materials and Methods: Twenty-four-hour ambulatory BPs of 195 patients with primary hypertension were measured. Systolic and diastolic BP measurements were recorded. We examined the MHR and 24-hour urine protein excretion in patients with RDHT.

Results: In our study, urinary protein excretion, which is a predictive indicator of target organ damage in patients with RDHT, was found to be higher than other groups. Furthermore, MHR, an oxidative stress and inflammation marker, was found to be higher in this patient group. Stepwise regression analysis revealed that MHR was an independent predictor of urinary protein excretion in the RDHT group.

Conclusion: In patients with RDHT, except for normal physiology, high nighttime BP measurements have a negative effect on all systems. Oxidative stress and inflammation are thought to play a role in this process in terms of target organ damage.