Association between type D personality traits and circadian blood pressure patterns: Focus on dipper vs non-dipper phenotypes

The non-dipper blood pressure pattern, characterized by an impaired nocturnal decline in blood pressure, is associated with an increased risk of cardiovascular and cognitive complications. Type D personality, defined by the components of negative affectivity and social inhibition, represents a psychological pattern linked to heightened stress response. This study aimed to investigate the association between Type D personality traits and the non-dipper blood pressure pattern. Between January and December 2023, a total of 182 patients evaluated for hypertension were screened, and 99 individuals who met the inclusion criteria and had valid 24-hour ambulatory blood pressure monitoring (ABPM) results were enrolled. Participants were classified as dipper (n = 49) or non-dipper (n = 50) based on the percentage decline in nocturnal blood pressure. Type D personality was assessed using the DS14 scale developed by Denollet. Blood pressure parameters were obtained using the Del Mar Reynolds Medical Tracker NIBP2 device. Group comparisons were performed with appropriate parametric or non-parametric tests. Logistic regression analysis was used to identify predictors of the non-dipper pattern, and receiver operating characteristic (ROC) analysis was conducted to evaluate the discriminative value of Type D personality components. Nighttime systolic and diastolic blood pressure values were significantly higher in the non-dipper group, accompanied by a markedly reduced physiological nocturnal dipping. Social inhibition (SI) and negative affectivity (NA) scores were significantly elevated in non-dippers compared with dippers (SI: 14.62 ± 3.36 vs. 7.10 ± 1.98; NA: 12.08 ± 2.12 vs. 5.96 ± 2.41; both p < 0.001). Correlation analyses demonstrated positive associations of SI and NA scores with nighttime systolic/diastolic blood pressure, and negative associations with systolic and diastolic dipping percentages. ROC analysis revealed high diagnostic accuracy for both SI (AUC: 0.986) and NA (AUC: 0.968), with sensitivity of 93–96% and specificity of 96–98%. Metabolic parameters showed higher fasting glucose levels and lower estimated glomerular filtration rate(eGFR) values in the non-dipper group (p < 0.05). Logistic regression identified SI and NA as independent predictors of the non-dipper blood pressure pattern. This study demonstrates a significant association between Type D personality traits and the non-dipper blood pressure pattern. However, given the cross-sectional design and potential confounding, these findings should be interpreted cautiously. Further large-scale and prospective studies are required before these findings can be translated into clinical practice.