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Vol 23, No 3 (2019)
ORIGINAL PAPERS
Published online: 2019-09-12
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Determinants of the circadian blood pressure pattern in hospitalized hypertensive patients

Martyna Zaleska, Olga Możeńska, Agnieszka Segiet, Jan Gierałtowski, Monika Petelczyc, Zbigniew Dubielski, Dariusz A. Kosior
DOI: 10.5603/AH.a2019.0013
·
Arterial Hypertension 2019;23(3):190-196.

open access

Vol 23, No 3 (2019)
ORIGINAL PAPERS
Published online: 2019-09-12

Abstract

Background. Non-dipping hypertension might be associated with increased cardiovascular risk and multiple diseases. The aim of our study was to assess if there are parameters identified in 24-hour ECG-Holter monitoring (ECG-Holter), transthoracic echocardiography (TTE), ECG parameters or laboratory data that allow prediction of circadian blood pressure profile (CBPP).

Material and methods. One hundred and three consecutive patients (male: 50.5%), who underwent 24-hour ambulatory BP measurement and ECG-Holter simultaneously were analyzed. We divided patients into 3 groups: dipping was defined as 10–20% (28.2%), non-dipping as < 10% (50.5%) fall in nocturnal BP and reverse-dipping as higher nocturnal than diurnal BP (21.4%). Additionally, we performed TTE and laboratory check-up in all patients. We built multivariable models for nocturnal fall in systolic BP (SBP) and CBPP.

Results. Multivariable model based on clinical factors was: nocturnal fall in SBP (%) = [13.28 – 0.11 × age – 8.33 × (dilated cardiomyopathy) – 5.95 × PAD – 6.02 × a-adrenolytic]. Multivariable model based on laboratory, echocardiographic and electrocardiographic parameters was: nocturnal fall in SBP (%) = [–27.28 + 1.47 × hemoglobin – 0.14 × CK-MB + 0.14 × maximal heart rate]. Multivariable model for CBPP based on clinical factors included use of beta- or alpha-adrenolytics or torasemide.

Conclusions. We proved that nocturnal fall in SBP and CBPP could be predicted based on ECG-Holter parameters, laboratory data and TTE results, as well as based on detailed medical history. These findings may have implications on care of patients with hypertension.

Abstract

Background. Non-dipping hypertension might be associated with increased cardiovascular risk and multiple diseases. The aim of our study was to assess if there are parameters identified in 24-hour ECG-Holter monitoring (ECG-Holter), transthoracic echocardiography (TTE), ECG parameters or laboratory data that allow prediction of circadian blood pressure profile (CBPP).

Material and methods. One hundred and three consecutive patients (male: 50.5%), who underwent 24-hour ambulatory BP measurement and ECG-Holter simultaneously were analyzed. We divided patients into 3 groups: dipping was defined as 10–20% (28.2%), non-dipping as < 10% (50.5%) fall in nocturnal BP and reverse-dipping as higher nocturnal than diurnal BP (21.4%). Additionally, we performed TTE and laboratory check-up in all patients. We built multivariable models for nocturnal fall in systolic BP (SBP) and CBPP.

Results. Multivariable model based on clinical factors was: nocturnal fall in SBP (%) = [13.28 – 0.11 × age – 8.33 × (dilated cardiomyopathy) – 5.95 × PAD – 6.02 × a-adrenolytic]. Multivariable model based on laboratory, echocardiographic and electrocardiographic parameters was: nocturnal fall in SBP (%) = [–27.28 + 1.47 × hemoglobin – 0.14 × CK-MB + 0.14 × maximal heart rate]. Multivariable model for CBPP based on clinical factors included use of beta- or alpha-adrenolytics or torasemide.

Conclusions. We proved that nocturnal fall in SBP and CBPP could be predicted based on ECG-Holter parameters, laboratory data and TTE results, as well as based on detailed medical history. These findings may have implications on care of patients with hypertension.

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Keywords

ambulatory blood pressure monitoring; circadian rhythm; hypertension; hypotensive therapy

About this article
Title

Determinants of the circadian blood pressure pattern in hospitalized hypertensive patients

Journal

Arterial Hypertension

Issue

Vol 23, No 3 (2019)

Pages

190-196

Published online

2019-09-12

DOI

10.5603/AH.a2019.0013

Bibliographic record

Arterial Hypertension 2019;23(3):190-196.

Keywords

ambulatory blood pressure monitoring
circadian rhythm
hypertension
hypotensive therapy

Authors

Martyna Zaleska
Olga Możeńska
Agnieszka Segiet
Jan Gierałtowski
Monika Petelczyc
Zbigniew Dubielski
Dariusz A. Kosior

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