Perirenal Fat Thickness Is Associated With Disturbed Circadian Blood Pressure Rhythm in Essential Hypertension.

The high PRFT group exhibited significantly higher prevalence of morning hypertension, nocturnal hypertension, and reverse-dipper pattern compared to the low PRFT group.

• Morning hypertension prevalence: 68.7% (Tertile 3) vs. 40.0% (Tertile 1)
• Nocturnal hypertension prevalence: 88.0% (Tertile 3) vs. 63.5% (Tertile 1)
• Reverse-dipper pattern prevalence: 20.5% (Tertile 3) vs. 7.1% (Tertile 1)
• All comparisons were statistically significant (all p < 0.05)
• Patients were stratified into PRFT tertiles in a cross-sectional study of 253 patients with essential hypertension

Each 1-mm increase in PRFT was independently associated with increased risks of morning hypertension, nocturnal hypertension, and reverse-dipper pattern after adjustment for multiple confounders.

• Each 1-mm increase in PRFT was associated with a 10.2% increased risk of morning hypertension
• Each 1-mm increase in PRFT was associated with a 15.2% increased risk of nocturnal hypertension
• Each 1-mm increase in PRFT was associated with a 9.9% increased risk of reverse-dipper pattern
• These associations remained independent after adjustment for multiple confounders including traditional adiposity indices

Traditional adiposity indices showed no independent associations with circadian BP rhythm disturbances.

• BMI, visceral fat area (VFA), and total fat area (TFA) showed no independent associations with morning hypertension, nocturnal hypertension, or reverse-dipper pattern
• This contrasted with PRFT, which retained independent associations after adjustment
• Adiposity indices were measured by abdominal CT

PRFT demonstrated the best discriminative performance for nocturnal hypertension among all fat indices, with performance improving when age was added.

• AUC for PRFT discriminating nocturnal hypertension was 0.685
• AUC improved to 0.720 upon inclusion of age
• PRFT outperformed BMI, VFA, and TFA in discriminating nocturnal hypertension

No significant association was observed between PRFT and short-term blood pressure variability (BPV).

• Short-term BPV was assessed via 24-hour ambulatory blood pressure monitoring (ABPM)
• PRFT was not significantly associated with short-term BPV despite its associations with circadian BP rhythm phenotypes
• This finding distinguished the role of PRFT in circadian rhythm disturbances from short-term variability

The study design was a cross-sectional analysis of 253 patients with essential hypertension using CT-measured adiposity and 24-hour ABPM.

• 253 patients with essential hypertension were included
• PRFT and other adiposity indices (BMI, VFA, TFA) were measured by abdominal CT
• Circadian BP rhythm and variability were assessed via 24-hour ambulatory blood pressure monitoring (ABPM)
• Patients were stratified into PRFT tertiles for comparative analysis