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Published online: 2019-07-02
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Valvular heart disease and different circadian blood pressure profiles

Martyna Zaleska, Olga Możeńska, Agnieszka Segiet, Jan Gierałtowski, Monika Petelczyc, Michał Zamojski, Dariusz A Kosior
DOI: 10.5603/FC.a2019.0074

open access

Ahead of print
Original Papers
Published online: 2019-07-02

Abstract

Valvular heart diseases (VHD) increase the risk of cardiovascular morbidity and mortality. Little is known about correlation between circadian blood pressure profile and VHD. The aim of the study was to clarify the association of dipping status and VHD prevalence. 103 consecutive patients (male: 50.5%), who underwent 24-hour ambulatory BP measurement and ECG-Holter simultaneously were analysed. 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%). VHD was assessed by transthoracic echocardiography and described as mild, moderate or severe regurgitation or stenosis accordingly. Further we compared severity of VHD, nocturnal fall pattern and ABPM features in all groups. We found no statistically significant associations between dipping pattern and frequency of VHD. We also found no statistical association between dipping status and severity of VHD. Our study showed some correlations between VHD severity and different ABPM parameters. Though dipping status obtained by ABPM did not influence severity of VHD, there were associations between ABPM outcomes and VHD. This finding may have important implications on care of patients with hypertension and VHD, though further studies are needed.

Abstract

Valvular heart diseases (VHD) increase the risk of cardiovascular morbidity and mortality. Little is known about correlation between circadian blood pressure profile and VHD. The aim of the study was to clarify the association of dipping status and VHD prevalence. 103 consecutive patients (male: 50.5%), who underwent 24-hour ambulatory BP measurement and ECG-Holter simultaneously were analysed. 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%). VHD was assessed by transthoracic echocardiography and described as mild, moderate or severe regurgitation or stenosis accordingly. Further we compared severity of VHD, nocturnal fall pattern and ABPM features in all groups. We found no statistically significant associations between dipping pattern and frequency of VHD. We also found no statistical association between dipping status and severity of VHD. Our study showed some correlations between VHD severity and different ABPM parameters. Though dipping status obtained by ABPM did not influence severity of VHD, there were associations between ABPM outcomes and VHD. This finding may have important implications on care of patients with hypertension and VHD, though further studies are needed.

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Keywords

circadian rhythm; hypertension; valvular heart disease;

About this article
Title

Valvular heart disease and different circadian blood pressure profiles

Journal

Folia Cardiologica

Issue

Ahead of print

Published online

2019-07-02

DOI

10.5603/FC.a2019.0074

Keywords

circadian rhythm
hypertension
valvular heart disease

Authors

Martyna Zaleska
Olga Możeńska
Agnieszka Segiet
Jan Gierałtowski
Monika Petelczyc
Michał Zamojski
Dariusz A Kosior

References (30)
  1. Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension: analysis of worldwide data. Lancet. 2005; 365(9455): 217–223.
  2. Guilbert JJ. The world health report 2002 - reducing risks, promoting healthy life. Educ Health (Abingdon). 2003; 16(2): 230.
  3. Millar-Craig MW, Bishop CN, Raftery EB. Circadian variation of blood-pressure. Lancet. 1978; 1(8068): 795–797.
  4. Pickering TG, Hall JE, Appel LJ, et al. Council on High Blood Pressure Research Professional and Public Education Subcommittee, American Heart Association. Recommendations for blood pressure measurement in humans: an AHA scientific statement from the Council on High Blood Pressure Research Professional and Public Education Subcommittee. J Clin Hypertens (Greenwich). 2005; 7(2): 102–109.
  5. Verdecchia P, Schillaci G, Reboldi G, et al. Original articles prognostic value of combined echocardiography and ambulatory blood pressure monitoring in hypertensive patients at low or medium cardiovascular risk. Ital Heart J. 2001; 2(4): 287–293.
  6. Verdecchia P, Schillaci G, Reboldi G, et al. Ambulatory blood pressure. An independent predictor of prognosis in essential hypertension. Hypertension. 1994; 24(6): 793–801.
  7. Zweiker R, Eber B, Schumacher M, et al. "Non-dipping" related to cardiovascular events in essential hypertensive patients. Acta Med Austriaca. 1994; 21(3): 86–89.
  8. Cuspidi C, Meani S, Salerno M, et al. Cardiovascular target organ damage in essential hypertensives with or without reproducible nocturnal fall in blood pressure. J Hypertens. 2004; 22(2): 273–280.
  9. Cuspidi C, Michev I, Meani S, et al. Reduced nocturnal fall in blood pressure, assessed by two ambulatory blood pressure monitorings and cardiac alterations in early phases of untreated essential hypertension. J Hum Hypertens. 2003; 17(4): 245–251.
  10. Ijiri H, Kohno I, Yin D, et al. Cardiac arrhythmias and left ventricular hypertrophy in dipper and nondipper patients with essential hypertension. Jpn Circ J. 2000; 64(7): 499–504.
  11. Nyström F, Malmqvist K, Lind L, et al. Nurse-recorded clinic and ambulatory blood pressures correlate equally well with left ventricular mass and carotid intima-media thickness. J Intern Med. 2005; 257(6): 514–522.
  12. Passino C, Magagna A, Conforti F, et al. Ventricular repolarization is prolonged in nondipper hypertensive patients: role of left ventricular hypertrophy and autonomic dysfunction. J Hypertens. 2003; 21(2): 445–451.
  13. Tsioufis C, Antoniadis D, Stefanadis C, et al. Relationships between new risk factors and circadian blood pressure variation in untreated subjects with essential hypertension. Am J Hypertens. 2002; 15(7 Pt 1): 600–604.
  14. Tsivgoulis G, Vemmos KN, Zakopoulos N, et al. Association of blunted nocturnal blood pressure dip with intracerebral hemorrhage. Blood Press Monit. 2005; 10(4): 189–195.
  15. Metoki H, Ohkubo T, Kikuya M, et al. Prognostic significance for stroke of a morning pressor surge and a nocturnal blood pressure decline: the Ohasama study. Hypertension. 2006; 47(2): 149–154.
  16. Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: a population-based study. Lancet. 2006; 368(9540): 1005–1011.
  17. Iung B, Baron G, Butchart EG, et al. A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease. Eur Heart J. 2003; 24(13): 1231–1243.
  18. Staessen J, Bieniaszewski L, O'Brien E, et al. Nocturnal Blood Pressure Fall on Ambulatory Monitoring in a Large International Database. Hypertension. 1997; 29(1): 30–39.
  19. Team RC. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna 2012: 2014.
  20. Rahman M, Griffin V, Heyka R, et al. Diurnal variation of blood pressure; reproducibility and association with left ventricular hypertrophy in hemodialysis patients. Blood Press Monit. 2005; 10(1): 25–32.
  21. Verdecchia P, Schillaci G, Borgioni C, et al. Circadian blood pressure changes and left ventricular hypertrophy in essential hypertension. Circulation. 1990; 81(2): 528–536.
  22. Balci B, Yilmaz O, Yesildag O. The influence of ambulatory blood pressure profile on left ventricular geometry. Echocardiography. 2004; 21(1): 7–10.
  23. Cuspidi C, Lonati L, Sampieri L, et al. Impact of nocturnal fall in blood pressure on early cardiovascular changes in essential hypertension. J Hypertens. 1999; 17(9): 1339–1344.
  24. Grandi AM, Broggi R, Jessula A, et al. Relation of extent of nocturnal blood pressure decrease to cardiovascular remodeling in never-treated patients with essential hypertension. Am J Cardiol. 2002; 89(10): 1193–1196.
  25. Cuspidi C, Michev I, Meani S, et al. Non-dipper treated hypertensive patients do not have increased cardiac structural alterations. Cardiovasc Ultrasound. 2003; 1: 1.
  26. Ferrara AL, Pasanisi F, Crivaro M, et al. Cardiovascular abnormalities in never-treated hypertensives according to nondipper status. Am J Hypertens. 1998; 11(11 Pt 1): 1352–1357.
  27. Sokmen G, Sokmen A, Aksu E, et al. The influence of ambulatory blood pressure profile on global and regional functions of the left and the right ventricles in orderly treated hypertensive patients. Echocardiography. 2008; 25(5): 465–472.
  28. Wang C, Zhang J, Liu X, et al. Reversed dipper blood-pressure pattern is closely related to severe renal and cardiovascular damage in patients with chronic kidney disease. PLoS One. 2013; 8(2): e55419.
  29. Jensen LW, Bagger JP, Pedersen EB. Twenty-four-hour ambulatory blood pressure and vasoactive hormones in valvular aortic disease. Blood Press. 1996; 5(5): 292–299.
  30. Dumonteil N, Vaccaro A, Despas F, et al. Transcatheter aortic valve implantation reduces sympathetic activity and normalizes arterial spontaneous baroreflex in patients with aortic stenosis. JACC Cardiovasc Interv. 2013; 6(11): 1195–1202.

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