Morning blood pressure surge is associated independently with orthostatic hypotension in hypertensive patients under treatment
Yükleniyor...
Tarih
2018
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Lippincott Williams & Wilkins
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Objective Morning blood pressure surge (MBPS) and orthostatic hypotension (OH) play a role in the occurrence of cardiovascular events. We aimed to investigate the association between MBPS and OH in hypertensive patients under treatment. Patients and methods We prospectively included 297 patients (mean age: 53.8 +/- 10.7 years, male/female: 101/196) with essential hypertension. Tilt table testing was performed for the diagnosis of OH. OH was classified into three groups as initial OH (0-15s), classical OH (15s to 3 min), and delayed OH (3-30 min). Patients were categorized into two main groups: patient with OH or without OH. We used sleep-through MBPS. The MBPS was calculated as the difference between the average blood pressure (BP) during the 2 h after awakening and the lowest night-time BP. Results We detected initial OH in two patients, classic OH in seven patients, delayed OH in 20 patients, and delayed OH with syncope in two patients. MBPS, thiazide diuretic, and alpha-blocker treatments were found to be associated independently with the occurrence of OH. Every 10 mmHg increase in MBPS was found to increase the rate of development of OH by 29.6%. The cut-off value of MBPS obtained by the receiver operator characteristic curve analysis was 35mmHg for the prediction of OH occurrence (sensitivity: 58.0%, specificity: 68.0%). The area under the curve was 0.657 (95% confidence interval: 0.553-0.771, P=0.004). Conclusion OH is a major problem in hypertensive patients. Increased MBPS, which can be detected easily by 24-h ambulatory BP monitor, predicts the occurrence of OH independently. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.
Açıklama
Anahtar Kelimeler
morning blood pressure surge, orthostatic hypotension, hypertension
Kaynak
Blood Pressure Monitoring
WoS Q Değeri
Q4
Scopus Q Değeri
Q2
Cilt
23
Sayı
4
