open access

Vol 5, No 2 (2001)
Prace oryginalne
Published online: 2001-06-15
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Blood Pressure Variability, Metabolic Profile and Target Organ Damage in Patients with Essential Hypertension

Marek Kabat, Mariola Pęczkowska, Marcin Mirocha, J. Janas, Marek Sznajderman, Andrzej Januszewicz
Nadciśnienie tętnicze 2001;5(2):93-102.

open access

Vol 5, No 2 (2001)
Prace oryginalne
Published online: 2001-06-15

Abstract

Background To assess the connection between metabolic profile, blood pressure and blood pressure variability, and target organ damage in patients (pts) with essential hypertension.

Material and methods 71 men with mild-to-moderate essential hypertension (HT) (age 20–60 years). In all pts 24 hour blood pressure monitoring (ABPM) was performed. Echocardiography, Doppler ultrasound examination of common carotid artery intima-media thickness (IMT) and microalbumin excretion (MA) were performed to evaluate target organ status. Blood sample were taken to assess cholesterol — total (CHOL), LDL, HDL, trigliceryde (TG) level, glucose serum concentration and insulin during the glucose load test (INS 0, INS 1, INS 2).

Results According to the insulin level 3 groups of pts were analyzed — group one: INS 0 above vs. below 12mIU/ml, group two: INS 0 above vs. below 25mIU/ml and group three: INS 1 above vs. below mean values for the whole group — 102mIU/ml. The pts in group one with INS 0 above 12 uIU/ml were characterized by higher BMI, left ventricle diastolic diameter (LVIDD) and left ventricle mass (LVM) and decreased fall of blood pressure at night in comparison to pts with INS 0 below this level. In group two increased BMI and higher systolic and diastolic blood pressure variability at night were observed in patients with INS 0 above 25 uIU/ml. In group three greater BMI and greater diastolic blood pressure variability during the day were observed in pts with INS 1 above mean values. According to the albumin excretion two groups of pts were assessed — with MA above and below 30 mg/24 h. Pts with MA above 30 mg/24 h were characterized by higher systolic and diastolic blood pressure during the day and the night as well as by lower night fall of diastolic blood pressure. To assess independent risk factors of target organ damage, the logistic regression was applied. It seems probable that high level of INS 0, INS 1, total cholesterol, LDL–cholesterol as well as low level of HDL–cholesterol are risk factors for hypertrophy of carotid artery wall in pts with hypertension. The risk of MA seems to be connected with values of systolic blood pressure during the day and systolic blood pressure variability at night.

Conclusions The hypertensives with higher insuline levels are characterized by higher blood pressure variability and lower diastolic blood pressure fall at night as well as more pronounced target organ lesions than hypertensives with lower insulin levels. In hypertensives with MA higher systolic and diastolic blood pressure values and lower diastolic blood pressure fall at night are observed. Hyperinsulinemia, high level of cholesterol, LDL-cholesterol, and low level of HDL-cholesterol seem to be the independent risk factors of vascular complications in hypertensive pts.

LDL-cholesterol, and low level of HDL-cholesterol seem to be the independent risk factors of vascular complications in hypertensive pts. The risk of microalbuminuria is connected with systolic blood pressure during the day and with systolic blood pressure variability at night

Abstract

Background To assess the connection between metabolic profile, blood pressure and blood pressure variability, and target organ damage in patients (pts) with essential hypertension.

Material and methods 71 men with mild-to-moderate essential hypertension (HT) (age 20–60 years). In all pts 24 hour blood pressure monitoring (ABPM) was performed. Echocardiography, Doppler ultrasound examination of common carotid artery intima-media thickness (IMT) and microalbumin excretion (MA) were performed to evaluate target organ status. Blood sample were taken to assess cholesterol — total (CHOL), LDL, HDL, trigliceryde (TG) level, glucose serum concentration and insulin during the glucose load test (INS 0, INS 1, INS 2).

Results According to the insulin level 3 groups of pts were analyzed — group one: INS 0 above vs. below 12mIU/ml, group two: INS 0 above vs. below 25mIU/ml and group three: INS 1 above vs. below mean values for the whole group — 102mIU/ml. The pts in group one with INS 0 above 12 uIU/ml were characterized by higher BMI, left ventricle diastolic diameter (LVIDD) and left ventricle mass (LVM) and decreased fall of blood pressure at night in comparison to pts with INS 0 below this level. In group two increased BMI and higher systolic and diastolic blood pressure variability at night were observed in patients with INS 0 above 25 uIU/ml. In group three greater BMI and greater diastolic blood pressure variability during the day were observed in pts with INS 1 above mean values. According to the albumin excretion two groups of pts were assessed — with MA above and below 30 mg/24 h. Pts with MA above 30 mg/24 h were characterized by higher systolic and diastolic blood pressure during the day and the night as well as by lower night fall of diastolic blood pressure. To assess independent risk factors of target organ damage, the logistic regression was applied. It seems probable that high level of INS 0, INS 1, total cholesterol, LDL–cholesterol as well as low level of HDL–cholesterol are risk factors for hypertrophy of carotid artery wall in pts with hypertension. The risk of MA seems to be connected with values of systolic blood pressure during the day and systolic blood pressure variability at night.

Conclusions The hypertensives with higher insuline levels are characterized by higher blood pressure variability and lower diastolic blood pressure fall at night as well as more pronounced target organ lesions than hypertensives with lower insulin levels. In hypertensives with MA higher systolic and diastolic blood pressure values and lower diastolic blood pressure fall at night are observed. Hyperinsulinemia, high level of cholesterol, LDL-cholesterol, and low level of HDL-cholesterol seem to be the independent risk factors of vascular complications in hypertensive pts.

LDL-cholesterol, and low level of HDL-cholesterol seem to be the independent risk factors of vascular complications in hypertensive pts. The risk of microalbuminuria is connected with systolic blood pressure during the day and with systolic blood pressure variability at night

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Keywords

hypertension; insulin resistance; microalbuminuria; blood pressure variability; target organ damage

About this article
Title

Blood Pressure Variability, Metabolic Profile and Target Organ Damage in Patients with Essential Hypertension

Journal

Arterial Hypertension

Issue

Vol 5, No 2 (2001)

Pages

93-102

Published online

2001-06-15

Bibliographic record

Nadciśnienie tętnicze 2001;5(2):93-102.

Keywords

hypertension
insulin resistance
microalbuminuria
blood pressure variability
target organ damage

Authors

Marek Kabat
Mariola Pęczkowska
Marcin Mirocha
J. Janas
Marek Sznajderman
Andrzej Januszewicz

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