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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 1, January/February 2017
16
AFRICA
converting enzyme inhibitors (ACEI), angiotensin receptor
blockers (ARB), beta-blocker (BB) and calcium channel blockers
(CCB) did not demonstrate any significant dfferences between the
groups. Of the laboratory parameters, no statistically significant
difference was found between high-density lipoprotein (HDL-C)
cholesterol, low-density lipoprotein (LDL-C) cholesterol, fasting
blood glucose (FBG), triglyceride (TG), total cholesterol (TC),
creatinine, haemoglobin and ejection fraction (EF) levels (Table
2). None of the patients were on nitrate treatment.
The 24-hour Holter data of the patients were evaluated and
inter-group comparisons were performed. In the dipper group,
the pulse rate (66.57
±
4.92 bpm) was significantly lower than
that of the non-dipper group (72.70
±
4.86 bpm) (
p
=
0.001).
No statistically significant differences were determined between
the groups with regard to the mean systolic and mean diastolic
blood pressures (
p
=
0.226,
p
=
0.749, respectively). Similarly,
there was no significant difference between the groups regarding
the day-time mean systolic and diastolic blood pressures (
p
=
0.802,
p
=
0.417, respectively). The night-time mean systolic
and diastolic blood pressure levels were, however, significantly
lower in the dipper group (
p
=
0.001,
p
≤ 0.001, respectively). The
percentage change in systolic and diastolic blood pressures was
significantly higher in the dipper than the non-dipper group (
p
≤
0.001,
p
≤ 0.001, respectively). The inter-group comparisons of
ABPM are presented in Table 3.
The mean TIMI frame counts of all three coronary arteries
were calculated in the dipper and non-dipper patient groups. In
the dipper group, the RCA TIMI frame count (16.83
±
3.70) was
significantly lower than that in the non-dipper group (21.63
±
3.44) (
p
<
0.001). In the dipper group, the Cx TIMI frame count
(21.28
±
3.52) was significantly lower than in the non-dipper
group (25.65
±
3.61) (
p
<
0.001). The LAD TIMI frame count
in the dipper group (34.20
±
2.80) was significantly lower
than in the non-dipper group (37.05
±
3.30) (
p
=
0.001). The
LAD corrected TIMI frame count in the dipper group (20.05
±
1.63) was significantly lower than in the non-dipper group
(21.74
±
1.95) (
p
=
0.001). In the dipper group, the mean TIMI
frame count (19.31
±
2.31) was significantly lower than in the
non-dipper group (22.94
±
2.61) (
p
<
0.001) (Table 4).
Table 1. Distribution of patients based on
demographic and clinical characteristics
Demographic and clinical parameters
Patients (n
=
60
)
Age (year
±
SD)
52.85
±
10.42
Female,
n
(%)
23 (38.3)
BMI (kg/m²
±
SD)
24.63
±
2.8
Smoking,
n
(%)
32 (53.3)
Drinking,
n
(%)
29 (48.3)
Hyperlipidaemia,
n
(%)
27 (45.0)
Diabetes mellitus
n
(%)
8 (13)
Antihypertensive drugs
ACEI,
n
(%)
21 (35.0)
ARB,
n
(%)
20 (33.3)
BB,
n
(%)
24 (40.0)
CCB,
n
(%)
22 (36.6)
HDL-C (mg/dl
±
SD)
(mmol/l)
47.63
±
13.21
1.23
±
0.34
LDL-C (mg/dl
±
SD)
(mmol/l)
133.55
±
40.91
3.46
±
1.06
FPG (mg/dl
±
SD)
(mmol/l)
95.82
±
15.04
5.32
±
0.83
TG (mg/dl
±
SD)
(mmol/l)
132.16
±
74.34
1.49
±
0.84
Total cholesterol (g/dl
±
SD)
(mmol/l)
185.16
±
42.7
4.80
±
1.11
Creatinine (mg/dl
±
SD)
(mmol/l)
0.79
±
0.18
69.84
±
15.91
Haemoglobin (g/dl
±
SD)
13.6
±
1.61
Ejection fraction (%
±
SD)
66.61
±
3.8
Continuous data are expressed as mean
±
SD, categorical data are
expressed as
n
(%). SD: standard deviation, ACEI: angiotensin
converting enzyme inhibitors, ARB: angiotensin receptor blocker, BB:
beta-blocker, CCB: calcium channel blockers, HDL-C: high-density
lipoprotein cholesterol, LDL-C: low-density lipoprotein cholesterol,
FPG: fasting plasma glucose, TG: triglycerides.
Table 2. Comparison of the demographic and clinical
characteristics between the groups
Demographic and clinical
parameters
Dipper
group
(
n
=
30)
Non-dipper
group
(
n
=
30)
p
-value
Age (year
±
SD)
51.63
±
12.68 54.07
±
8.17 0.381*
Gender
Male,
n
(%)
16 (53.3)
21 (70.0)
0.184
#
Female,
n
(%)
14 (46.7)
9 (30.0)
BMI (kg/m²
±
SD)
23.79
±
2.81 25.47
±
2.92
0.027
*
Smoking,
n
(%)
14 (46.7)
18 (60.0)
0.301
#
Drinking,
n
(%)
11 (36.7)
8 (26.7)
0.405
#
Hyperlipidaemia,
n
(%)
13 (43.3)
14 (46.7)
0.895
#
Diabetes mellitus,
n
(%)
3 (10.0)
5 (16.7)
0.448
#
Symptoms
Chest pain,
n
(%)
30 (100)
30 (100)
1
#
Palpitation,
n
(%)
14 (46.6)
15 (50)
0.823
#
Dsypnoea,
n
(%)
9 (30.0)
10 (33.3)
0.437
#
Restlessness,
n
(%)
8 (26.6)
14 (46.6)
0.248
#
Dizziness,
n
(%)
8 (26.6)
12 (40.0)
0.312
#
Antihypertensive drugs
ACEI,
n
(%)
11 (36.7)
10 (33.3)
0.737
#
ARB,
n
(%)
10 (33.3)
10 (33.3)
1
#
CCB,
n
(%)
9 (30.0)
13 (43.3)
0.234
#
BB,
n
(%)
12 (40.0)
12 (40.0)
1
#
Statin,
n
(%)
9 (30.0)
13 (43.3)
0.234
#
HDL-C (mg/dl
±
SD)
(mmol/l)
47.23
±
13.51
(1.22
±
0.35)
48.03
±
12.91
(1.24
±
0.33)
0.815*
LDL-C (mg/dl
±
SD)
(mmol/l)
135.55
±
42.16
(3.51
±
1.09)
131.56
±
39.67
(3.41
±
1.03)
0.707*
FPG (mg/dl
±
SD)
(mmol/l)
93.97
±
15.89
(5.22
±
0.88)
97.63
±
14.22
(5.42
±
0.79)
0.350*
TG (g/dl
±
SD)
(mmol/l)
114.50
±
59.67
(1.29
±
0.67)
149.83
±
89.09
(1.69
±
1.01)
0.076*
Total cholesterol (g/dl
±
SD)
(mmol/l)
188.00
±
44.08
(4.87
±
1.14)
182.33
±
41.47
(4.72
±
1.07)
0.610*
Creatinine (mg/dl
±
SD)
(mmol/l)
0.81
±
0.19
(71.60
±
16.80)
0.77
±
0.18
(68.07
±
15.91)
0.404*
Haemoglobin (g/dl
±
SD)
13.56
±
1.82 13.70
±
1.41 0.728*
Ejection fraction (%
±
SD)
66.40
±
4.10 66.83
±
3.61 0.666*
Continuous data are expressed as mean
±
SD, categorical data are
expressed as
n
(%).
*Chi-squared test,
#
Independent samples
t
-test, statistical significance
level is
p
<
0.05 (bold values).
SD: standard deviation, ACEI: Angiotensin converting enzyme inhibi-
tors, ARB: angiotensin receptor blocker, BB: beta-blocker, CCB:
calcium channel blockers, HDL-C: high-density lipoprotein cholester-
ol, LDL-C: low-density lipoprotein cholesterol, FPG: fasting plasma
glucose, TG: triglycerides.