Pearson's correlation coefficients among objective parameters for sleep disturbances, ambulatory physical activity, and nocturnal SBP fall in all subjects and subgroup patients without anti-hypertensive medications.

<p>The parameters of objective sleep disturbances and ambulatory physical activity were natural logarithm-transformed (ln) to achieve a normal distribution. In all subjects, time awake after sleep onset (r = -0.150, P = 0.009) and awake physical activity (r = 0.164, P = 0.004) were significantly associated with nocturnal SBP fall (Fig 1A). In subgroup patients without anti-hypertensive medications, only awake physical activity (r = 0.344, P < 0.001) were significantly associated with nocturnal SBP fall (Fig 1B). SBP denotes systolic blood pressure. r: Pearson's correlation coefficient.</p

Plasma BDNF independently associated with reverse-dipper pattern of nocturnal blood pressure change.

<p>Multiple logistic regression analyses were performed. The covariates included age, male sex, classical cardiovascular risk factors (body mass index, current smoking, cardiovascular disease history, dyslipidemia, diabetes mellitus, eGFR), medical hypertension treatment (calcium-channel blocker, α or β blocker, ACE inhibitor or ARB, diuretic agent), AHI and BDNF. BDNF was natural logarithm-transformed (ln) to achieve a normal distribution. OR; odds ratio, CI; confidence interval, eGFR; estimated glomerular filtration rate, ACE: angiotensin converting enzyme, ARB; angiotensin receptor blocker, AHI; apnea hypopnea index, BDNF; brain-derived neurotrophic factor.</p

Clinical characteristics of subjects (n = 250).

<p>Data are presented as the mean ± standard deviation and number (%) for dichotomous variables. eGFR; estimated glomerular filtration rate, ACE; angiotensin converting enzyme, ARB: angiotensin receptor blocker, AHI; apnea hypopnea index, ABPM; ambulatory blood pressure monitoring, SBP; systolic blood pressure, DBP; diastolic blood pressure. Overall P values represent the 4-group comparison of means (ANOVA F-test) or percentage (chi-square test).</p><p>*P<0.05,</p><p>**P<0.01 vs. dippers. (post hoc test, Bonferroni correction).</p

Multiple linear regression analyses among sleep quality, awake physical activity and nocturnal SBP fall.

<p>Multiple linear regression analyses among sleep quality, awake physical activity and nocturnal SBP fall.</p

Correlation coefficients between time awake after sleep onset, awake physical activity and clinical factors.

<p>Correlation coefficients between time awake after sleep onset, awake physical activity and clinical factors.</p

Plasma BDNF in patients divided into extreme-dippers, dippers, non-dippers, and reverse-dippers based on changes in nocturnal blood pressure.

<p>BDNF was natural logarithm-transformed (ln) to achieve a normal distribution. Each column represents the mean ± standard deviation. The overall P value for the 4-group comparison of means was calculated using an ANOVA F-test, while a post hoc test with Bonferroni correction was used to compare with dippers. There were significant differences in plasma BDNF among the 4-groups (P<0.001), and its level in the reverse dippers was significantly lower than in the dippers.</p

Clinical characteristics of subjects (n = 303).

<p>Clinical characteristics of subjects (n = 303).</p

Association of plasma BDNF with HRV parameters.

<p>Pearson's correlation coefficients between the HRV parameters and BDNF were calculated. All parameters of HRV and BDNF were natural logarithm-transformed (ln) to achieve a normal distribution. HRV; heart rate variability, SDNN; standard deviation of the NN(RR) interval, SDANN5; standard deviation of average of NN intervals for each 5 minute period, CVRR; coefficient of variation R-R interval, LF; low frequency power, HF; high frequency power, LF/HF; the ratio of LF to HF, BDNF; brain-derived neurotrophic factor.</p

Correlation coefficients between nocturnal SBP fall and clinical factors.

<p>Correlation coefficients between nocturnal SBP fall and clinical factors.</p

Plasma brain-derived neurotrophic factor concentration is a predictor of chronic kidney disease in patients with cardiovascular risk factors – Hyogo Sleep Cardio-Autonomic Atherosclerosis study

<div><p>Background</p><p>Brain-derived neurotrophic factor (BDNF) has been shown to have protective effects against cardiovascular diseases and death through neural and non-neural pathways via tropomyosin-related kinase B signaling. However, it is not known whether plasma BDNF concentration is a predictor of chronic kidney disease (CKD).</p><p>Design</p><p>This study was conducted as a prospective cohort study as part of the Hyogo Sleep Cardio-Autonomic Atherosclerosis.</p><p>Methods</p><p>We measured plasma BDNF concentration in 324 patients without CKD, defined as an estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73m², and with cardiovascular risk factors. As potential confounders, sleep condition, nocturnal hypertension, and autonomic function were quantitatively examined. The patients were followed for a median 37 months (range 2–59 months) and occurrence of CKD was noted.</p><p>Results</p><p>Plasma BDNF concentration was significantly and independently associated with CKD development, which occurred in 38 patients (11.7%). Kaplan-Meier analysis revealed that patients with reduced plasma BDNF concentration exhibited a significantly (p = 0.029) greater number of CKD events as compared to those with a higher concentration. Moreover, comparisons of key subgroups showed that the risk of CKD in association with low plasma BDNF concentration was more prominent in patients with a greater reduction of nocturnal systolic blood pressure, better movement index, higher standard deviations of the NN(RR) interval or average NN(RR) interval for each 5-minute period, and without past cardiovascular disease events, smoking habit, or albuminuria.</p><p>Conclusions</p><p>Plasma BDNF concentration is an independent predictor for development of CKD in patients with cardiovascular risk factors.</p></div