Artículos de revistas
Absence Of Nocturnal Dipping Is Associated With Stroke And Myocardium Infarction [la Ausencia De Descenso Nocturno De La Presión Arterial Se Asocia A Accidente Cerebrovascular E Infarto De Miocardio]
Registro en:
Arquivos Brasileiros De Cardiologia. , v. 94, n. 1, p. 74 - 80, 2010.
0066782X
2-s2.0-77951617434
Autor
De Melo R.O.V.
Toledo J.C.Y.
Loureiro A.A.C.
Cipullo J.P.
Moreno Jr. H.
Martin J.F.V.
Institución
Resumen
Background: The arterial hypertension varies in according to the circadian cycle, presenting physiologic fall of blood pressure (BP) during sleep (dipping). The absence of this fall or its increase associates to higher incidence of target-organ damages. Objective: To analyze the prevalence of dipping in hypertensive individuals, to correlate dipping to the blood pressure levels, clinic, and socio-demographic factors, and biochemical characteristics and to associate it cardiovascular events (stroke and myocardial infarction). Methods: Hypertensive individuals were submitted to the ambulatory blood pressure monitoring. Presence of dipper was defined as fall ≥10% of the systolic BP of the day for sleep. Results: 163evaluated patients were divided in dippers (D, n=53) and nondippers (ND, n=110). Between the groups there was not significant difference to the age, sex, race, time of hypertension, glycemia, LDL-cholesterol, total cholesterol, triglycerides, schooling, smoking, and history of diabetes. D presented BP higher than the ND during the day and lower during sleep. ND had higher body mass index (BMI) (p=0.0377), lower level of HDL-cholesterol (p=0.0189), and higher pulse pressure during sleep (p=0.0025). History of stroke alone (p=0,046) and combined with myocardial infarction (p=0.032) were more frequent in nondippers individuals. In the logistic regression, only ND was associated independently with stroke or myocardial infarction. Conclusion: ND was associated in an independent way with the target-organ damages analyzed, what demonstrates its importance and strengthens the necessity of more aggressive treatment with objective to reach BP goals e, consequently, to prevent the development of new cardiologic and cerebrovascular events. 94 1 74 80 IV Diretriz para uso da monitorização ambulatorio da presión arterial - II Diretriz para uso da monitorização residencial da presión arterial IV MAPA / II MRPA (2005) Arq Bras Cardiol, 85 (SUPPL. 2), pp. 1-18. , Sociedade Brasileira de Cardiologia Clement, D.L., De Buvzere, M.L., De Bacquer, D.A., De Leeuw, P.W., Duprez, D.A., Fagard, R.H., Office versus Ambulatory Pressure Study Investigators. Prognostic value of ambulatory blood-pressure recordings in patients with treated hypertension (2003) N Eng J Med, 348 (24), pp. 2407-2415 Dolan, E., Stanton, A., Thijs, L., Hinedi, K., Atkins, N., McClory, S., Hond, E.D., O'Brien, E., Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: The Dublin outcome study (2005) Hypertension, 46 (1), pp. 156-161. , DOI 10.1161/01.HYP.0000170138.56903.7a Ben-Dov, I.Z., Kark, J.D., Ben-Ishay, D., Mekler, J., Ben-Arie, L., Bursztyn, M., Predictors of all-cause mortality in clinical ambulatory monitoring: Unique aspects of blood pressure during sleep (2007) Hypertension, 49 (6), pp. 1235-1241. , DOI 10.1161/HYPERTENSIONAHA.107.087262 Giorgi, D.M.A., Monitorização ambulatorio da presión arterial como método de avaliação do pronóstico en hipertensión arterial (1996) Arq Bras Cardiol, 67 (2), pp. 145-148 Staessen, J.A., Thijs, L., Fagard, R., O'Brien, E.T., Clement, D., De Leeuw, P.W., Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators (1999) JAMA, 282 (6), pp. 539-546 Diagnosis and classification of Diabetes Mellitus (2004) Diabetes Care, 27 (SUPPL. 1), pp. S5-S10. , American Diabetes Association Knowler, W.C., Barrett-Connor, E., Fowler, S.E., Hamman, R.F., Lachin, J.M., Walker, E.A., Nathan, D.M., Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin (2002) New England Journal of Medicine, 346 (6), pp. 393-403. , DOI 10.1056/NEJMoa012512 IV Diretriz brasileira sobre dislipidemias e prevenção da doença aterosclerótica (2007) Arq Bras Cardiol, 88 (SUPPL. 1), pp. 2-19. , Sociedade Brasileira de Cardiologia Friedewald, W.T., Levy, R.I., Fredrickson, D.S., Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge (1972) Clin Chem, 18 (6), pp. 499-502 Kario, K., Pickering, T.G., Matsuo, T., Hoshide, S., Schwartz, J.E., Shimada, K., Stroke prognosis and abnormal nocturnal blood pressure falls in older hypertensives (2001) Hypertension, 38 (4), pp. 852-857 Anan, F., Takahashi, N., Ooie, T., Yufu, K., Saikawa, T., Yoshimatsu, H., Role of insulin resistance in nondipper essential hypertensive patients (2003) Hypertension Research, 26 (9), pp. 669-676. , DOI 10.1291/hypres.26.669 Del Compare, M.E., D'Agostino, D., Ferraris, J.R., Boldrini, G., Waisman, G., Krmar, R.T., Twenty-four-hour ambulatory blood pressure profiles in liver transplant recipients (2004) Pediatric Transplantation, 8 (5), pp. 496-501. , DOI 10.1111/j.1399-3046.2004.00192.x Torun, D., Sezer, S., Arat, Z., Pelit, A., Yigit, F., Ozdemir, F.N., The frequency of combined target organ damage and the beneficial effect of ambulatory blood pressure monitoring in never treated mild-to-moderate hypertensive patients (2005) International Heart Journal, 46 (6), pp. 1073-1082. , http://www.jstage.jst.go.jp/article/ihj/46/6/46_1073, DOI 10.1536/ihj.46.1073 Davidson, M.B., Vidt, D.G., Hoogwerf, B.J., Brotman, D.J., Relation of diurnal blood pressure variation and triglyceride-to-high- density lipoprotein cholesterol ratio in patients without diabetes mellitus (2005) Am J Cardiol, 95 (1), pp. 123-126 Davidson, M.B., Hix, J.K., Vidt, D.G., Brotman, D.J., Association of impaired diurnal blood pressure variation with a subsequent decline in glomerular filtration rate (2006) Arch Intern Med, 166 (8), pp. 846-852 Jerrard-Dunne, P., Mahmud, A., Feely, J., Circadian blood pressure variation: Relationship between dipper status and measures of arterial stiffness (2007) Journal of Hypertension, 25 (6), pp. 1233-1239. , DOI 10.1097/HJH.0b013e3280eec79f, PII 0000487220070600000010 Muxfeldt, E.S., Salles, G.F., Pulse pressure or dipping pattern: Which one is a better cardiovascular risk marker in resistant hypertension? (2008) J Hypertens, 26 (5), pp. 878-884 Brotman, D.J., Davidson, M.B., Boumitri, M., Vidt, D.G., Impaired diurnal blood pressure variation and all-cause mortality (2008) Am J Hypertens, 21 (1), pp. 92-97 Ortega, K.C., Mion Jr., D., Qual o melhor determinante do pronóstico pela monitorizaç ão ambulatorio da presión arterial: Ausencia de descenso da presión durante o sueño o elevação rápida da presión pela manhã? (2005) Arq Bras Cardiol, 85 (3), pp. 208-209 Shinohata, R., Nakatsu, T., Yuki, Y., Nishitani, A., Mashima, K., Toyonaga, S., Ogawa, H., Kusachi, S., Association of augmentation index of radial pressure wave form with diurnal variation pattern of blood pressure in untreated patients with essential hypertension (2008) Journal of Hypertension, 26 (3), pp. 535-543. , DOI 10.1097/HJH.0b013e3282f2fdb6, PII 0000487220080300000024 Henskens, L.H., Kroon, A.A., Van Oostenbrugge, R.J., Haest, R.J., Lodder, J., De Leeuw, P.W., Different classifications of nocturnal blood pressure dipping affect the prevalence of dippers and nondippers and the relation with target-organ damage (2008) Journal of Hypertension, 26 (4), pp. 691-698. , DOI 10.1097/HJH.0b013e3282f4225f, PII 0000487220080400000014 Safar, M.E., Systolic blood pressure, pulse pressure and arterial stiffness as cardiovascular risk factors (2001) Current Opinion in Nephrology and Hypertension, 10 (2), pp. 257-261. , DOI 10.1097/00041552-200103000-00015 Laurent, S., Cockcroft, J., Van Bortel, L., Boutouyrie, P., Giannattasio, C., Hayoz, D., Pannier, B., Struijker-Boudier, H., Expert consensus document on arterial stiffness: Methodological issues and clinical applications (2006) European Heart Journal, 27 (21), pp. 2588-2605. , DOI 10.1093/eurheartj/ehl254 Verdecchia, P., Schillaci, G., Borgioni, C., Ciucci, A., Pede, S., Porcellati, C., Ambulatory pulse pressure: A potent predictor of total cardiovascular risk in hypertension (1998) Hypertension, 32 (6), pp. 983-988 Morillo, M.G., Amato, M.C., Cendon Filha, S.P., Twenty-four hour blood pressure record for smokers and nonsmokers (2006) Arq Bras Cardiol, 87 (4), pp. 504-511 Kotsis, V., Stabouli, S., Bouldin, M., Low, A., Toumanidis, S., Zakopoulos, N., Impact of obesity on 24-hour ambulatory blood pressure and hypertension (2005) Hypertension, 45 (4), pp. 602-607. , DOI 10.1161/01.HYP.0000158261.86674.8e Bjorklund, K., Lind, L., Andren, B., Lithell, H., The majority of nondipping men do not have increased cardiovascular risk: A population-based study (2002) Journal of Hypertension, 20 (8), pp. 1501-1506. , DOI 10.1097/00004872-200208000-00011 Ohkubo, T., Hozawa, A., Yamaguchi, J., Kikuya, M., Ohmori, K., Michimata, M., Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: The Ohasama study (2002) J Hypertens, 20 (11), pp. 2183-2189 Dimsdale, J.E., Coy, T., Ancoli-Israel, S., Mills, P., Clausen, J., Ziegler, M.G., Sympathetic nervous system alterations in sleep apnea: The relative importance of respiratory disturbance, hypoxia, and sleep quality (1997) Chest, 111 (3), pp. 639-642 Hoshide, S., Kario, K., Determinants of nondipping in nocturnal blood pressure and specific nonpharmacological treatments for nocturnal hypertension (2008) Am J Hypertens, 21 (9), p. 968 Fujii, T., Uzu, T., Nishimura, M., Takeji, M., Kuroda, S., Nakamura, S., Inenaga, T., Kimura, G., Circadian rhythm of natriuresis is disturbed in nondipper type of essential hypertension (1999) American Journal of Kidney Diseases, 33 (1), pp. 29-35 Kimura, G., Kidney and circadian blood pressure rhythm (2008) Hypertension, 51 (4), pp. 827-828. , DOI 10.1161/HYPERTENSIONAHA.108.110213, PII 0000426820080400000007 Birkenhager, A.M., Van Der Meiracker, A.H., Causes and consequences of a non-dipping blood pressure profile (2007) Netherlands Journal of Medicine, 65 (4), pp. 127-131 Peixoto, A.J., White, W.B., Circadian blood pressure: Clinical implications based on the pathophysiology of its variability (2007) Kidney Int, 71 (9), pp. 855-860 Nakamura, K., Oita, J., Yamaguchi, T., Nocturnal blood pressure dip in stroke survivors: A pilot study (1995) Stroke, 26 (8), pp. 1373-1378 Rashid, P., Leonardi-Bee, J., Bath, P., Blood Pressure Reduction and Secondary Prevention of Stroke and Other Vascular Events: A Systematic Review (2003) Stroke, 34 (11), pp. 2741-2748. , DOI 10.1161/01.STR.0000092488.40085.15 Birns, J., Markus, H., Kalra, L., Blood pressure reduction for vascular risk: Is there a price to be paid? (2005) Stroke, 36 (6), pp. 1308-1313 Pedullà, M., Silvestri, R., Lasco, A., Mento, G., Lanuzza, B., Sofia, L., Sleep structure in essential hypertensive patients: Differences between dippers and non-dippers (1995) Blood Press, 4 (4), pp. 232-237 Loredo, J.S., Ancoli-Israel, S., Dimsdale, J.E., Sleep quality and blood pressure dipping in obstructive sleep apnea (2001) American Journal of Hypertension, 14 (9 I), pp. 887-892. , DOI 10.1016/S0895-7061(01)02143-4, PII S0895706101021434