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

Martyna Zaleska1, Olga Możeńska1, Agnieszka Segiet1, Jan Gierałtowski2, Monika Petelczyc2, Zbigniew Dubielski1, Dariusz A. Kosior3
DOI: 10.5603/AH.a2019.0013
·
Arterial Hypertension 2019;23(3):190-196.
Affiliations
  1. Department of Cardiology and Hypertension, Central Research Hospital, the Ministry of the Interior and Administration, Warsaw, Poland
  2. Faculty of Physics, Warsaw University of Technology, Warsaw, Poland
  3. Department of Applied Physiology, Mossakowski Institute of Experimental and Clinical Medicine, Polish Academy of Sciences, Warsaw

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)

Article type

Original paper

Pages

190-196

Published online

2019-09-12

Page views

882

Article views/downloads

666

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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