+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Long-term (four years) follow-up of patients with treated nocturnal hypertension assessed by ambulatory blood pressure monitoring



Long-term (four years) follow-up of patients with treated nocturnal hypertension assessed by ambulatory blood pressure monitoring



Revista Portuguesa de Cardiologia 20(2): 135-50; Discussion 153-4



Nocturnal Hypertension (NH) is an independent risk factor for cardiovascular morbidity and mortality (M-M). However, an inappropriate decrease in diastolic BP during the night significantly increases morbidity. There are no prospective studies on the long-term consequences on M-M in treated NH. We accordingly studied M-M in 107 consecutive patients with treated NH, assessed by ambulatory blood pressure monitoring (ABPM), during a four-year follow-up. From the initial 107 patients six died (5 from brain or cardiovascular causes). In 65 patients it was possible to repeat the ABPM during the follow-up period. They were hypertensive patients class I-II (JNC IV) 62 +/- 10 years old, 56 were male and were observed before and after starting treatment on a four-year follow-up period. We considered age, sex, body mass index, previous cerebral and cardiovascular accidents, type and number of drugs administered, smoking habits, plasma cholesterol, glycemia, and causal and ambulatory blood pressure monitoring (ABPM) (24 hr, 6 am-10 am, 10 pm-6 am and pulse pressure) before and after follow-up, dipper status and the period of follow-up. The patients whom died were older and had a significantly higher systolic blood pressure compared to the survivors. We considered two groups: with (A - n = 18) or without (B - n = 47) cerebral and cardiac morbidity. The A group had more previous cerebral and cardiovascular accidents (p = 0.05), a more intensive treatment (p = 0.02), and a greater fall in diastolic blood pressure (DBP) during the night in both absolute and percentage numbers, after treatment, than the B group. However, after regression analysis, the only independent risk marker differentiating between the two groups was the percentage fall in the DBP after treatment (dipper phenomenon) (p = 0.01). In 65 treated hypertensive (NH) patients assessed by ABPM before and after treatment (four-year follow-up) we identified a group with cerebral and cardiovascular morbidity. These patients, in contrast with another group with no morbidity, had more previous cerebral and cardiovascular accidents, they were more intensively treated, and they had a greater fall in diastolic blood pressure after therapy (absolute and percentage values). However, after regression analysis the diastolic nocturnal blood pressure dipper phenomenon after treatment was the only risk marker associated with morbidity. In such cases it is possible that treatment guided by ABPM can decrease morbidity.

(PDF emailed within 1 workday: $29.90)

Accession: 046567312

Download citation: RISBibTeXText

PMID: 11293873


Related references

The Effect of Long Term CPAP Treatment on Blood Pressure in Patients With Obstructive Sleep Apnea Syndrome and Hypertension - Sphygmomanometer Measurement Versus Ambulatory Blood Pressure Monitoring. Chest Journal 144(4): 994a-994b, 2013

Long-term reproducibility and usefulness of daytime recording of noninvasive 24-hour ambulatory blood pressure monitoring in borderline hypertension: a two-year follow-up study. Clinical and Experimental Hypertension 18(5): 637-657, 1996

Reproducibility of nocturnal blood pressure reduction rate and the prevalence of "non-dippers" using 48-hour ambulatory blood pressure monitoring in patients with essential hypertension. Annals of the New York Academy of Sciences 783: 330-332, 1996

Nocturnal decline in blood pressure is attenuated by NaCl loading in salt-sensitive patients with essential hypertension: noninvasive 24-hour ambulatory blood pressure monitoring. Hypertension 30(2 Pt 1): 163-167, 1997

Blood pressure-lowering effect of the sodium glucose co-transporter-2 inhibitor ertugliflozin, assessed via ambulatory blood pressure monitoring in patients with type 2 diabetes and hypertension. Diabetes, Obesity and Metabolism 17(8): 805-808, 2016

Efficacy of an olmesartan medoxomil-based treatment algorithm in patients with hypertension and type 2 diabetes: analysis of diurnal blood pressure control as assessed by 24-hour ambulatory blood pressure monitoring. Therapeutic Advances in Cardiovascular Disease 4(5): 285-293, 2011

Evaluation of the antihypertensive effect of L-arginine supplementation in patients with mild hypertension assessed with ambulatory blood pressure monitoring. Medical Science Monitor 16(5): Cr266-Cr271, 2010

Elevated nocturnal blood pressure assessed by ambulatory automatic monitoring during a stay at high altitude. European Journal Of Applied Physiology & Occupational Physiology. 70(3): 258-262, 1995

Efficacy of renal denervation with a standard EP catheter in the 24-h ambulatory blood pressure monitoring-long-term follow-up. International Journal of Cardiology 157(3): 447-448, 2013

Masked hypertension assessed by ambulatory blood pressure versus home blood pressure monitoring: is it the same phenomenon?. American Journal of Hypertension 18(6): 772-778, 2005

Antihypertensive efficacy of olmesartan medoxomil and candesartan cilexetil assessed by 24-hour ambulatory blood pressure monitoring in patients with essential hypertension. Clinical Drug Investigation 23(7): 419-430, 2003

Long-term blood pressure monitoring by office and 24-h ambulatory blood pressure in renal transplant patients: a longitudinal study. Nephrology, Dialysis, Transplantation 2018, 2018

Correlation between blood pressure changes assessed by 24-hour ambulatory blood pressure monitoring and urine microalbuminuria excretion rate in normal and essential hypertension. Korean Journal of Internal Medicine 9(1): 32-38, 1994

Long-term ambulatory follow-up of hypertension patients with low renin activity in blood. Terapevticheskii Arkhiv 74(9): 57-59, 2002

Morning rise of blood pressure assessed by home blood pressure monitoring is associated with left ventricular hypertrophy in hypertensive patients receiving long-term antihypertensive medication. Hypertension Research 30(10): 903-911, 2007