Diurnal blood pressure profile in patients with hypertension and coronary artery disease confirmed by angiography

Abstract

Background Hypertension is a common risk factor of coronary artery disease. Ambulatory blood pressure monitoring (ABPM) is a recognized predictive method of risk evaluation of cardiovascular events in patients with history of hypertension. The aim of present study was the analysis of diurnal blood pressure (BP) profile in patients with coronary artery disease (CAD) confirmed by coronary angiography.
Material and methods The study was performed in group of 279 patients who underwent coronary angiography. Enrolled patients were divided into two groups: A group - with significant coronary artery stenosis (stenosis > 70%) (n = 196) and B - without coronary artery stenosis (n = 83). Two weeks after coronary angiography office BP measurement and ABPM were performed. Day records were performed every 20 minutes between 8.00 and 20.00 and night records every 30 minutes between 22.00 and 6.00. Patients with night dip of blood pressure < 10% of day values was classify as non-dippers. Abnormal value of blood pressure was ≥ 135/80 mm Hg for 24 hour measurement, ≥ 135/85 mm Hg for day and ≥ 120/70 mm Hg for night.
Results Significant differences between group A and groups B were observed only in night systolic BP (124 ± 14 vs. 117 ± 14 mm Hg, p < 0,01) and diastolic BP (68 ± 9 vs. 65 ± 8 mm Hg, p < 0,02). In group A in comparison with group B there were more non-dippers (72% vs. 54%, p < 0,05). In group A less patients reached normal BP values at night than in group B (36% vs. 51, p < 0,02). Mean value of diastolic BP measured in office was lower in group A than in B (78 ± 13 mm Hg vs. 81 ± 11 mm Hg, p < 0,05).
Conclusions CAD can play significant role in disruption of diurnal blood pressure profile. Office BP measurements cannot be sufficient in optimal regulation of BP in patients with CAD.