Research Article
Year 2018,
Volume: 45 Issue: 4, 379 - 386, 13.12.2018
Abstract
Amaç: Non-dipper kan basıncının (KB) uç organ hasarı ve
ölümcül - ölümcül olmayan kardiyovasküler hastalıklarla (KVH) anlamlı şekilde
ilişkili olduğu gösterilmiştir. Kardiyovasküler (KV) olay riskinde artış
bulunan bireylerde sistematik KV risk değerlendirmesi önerilir. SCORE risk
sistemi, ilk ölümcül aterosklerotik olayın 10 yıllık riskini değerlendirir. Bu
çalışmanın amacı hipertansiyon (HT)hastalarında non-dipper KB ile SCORE risk
sistemi arasındaki bir ilişki olup olmadığının araştırılmasıdır.
Yöntemler: Bu çalışma retrospektif bir çalışmadır ve
esansiyel HT tanısı konulan ardışık 213 hastayı içermektedir. Non-dipper ve
dipper hasta grupları 24 saatlik ambulatuar kan basıncı izlemine (AKBİ) göre belirlendi.
SCORE sistemine göre yaş, cinsiyet, sigara kullanımı, sistolik kan basıncı
(SKB) ve total kolesterol (TK) gibi risk faktörleri kullanılarak 10 yıllık
ölümcül KV olay riski hesaplandı.
Bulgular: Non-dipper HT hasta grubunda SCORE risk sistemi anlamlı olarak
yüksek saptandı (p=0.017). Ayrıca sigara içme alışkanlığı sıklığı ve TK
değerleri non-dipper
HT’li hasta grubunda anlamlı olarak daha yüksek saptandı. Diğer demografik,
klinik ve laboratuvar parametreler iki grup arasında benzerdi. SCORE risk oranı
ile gece sistolik ve diyastolik KB’leri arasında orta derecede olmasına rağmen
anlamlı pozitif korelasyon izlendi (r = 0.354, p < 0.001; r = 0.339,
p<0.001; sırasıyla)
Sonuç: Bu çalışmada ilk defa non-dipper HT ile SCORE risk
sistemi arasında önemli bir ilişki olduğu gösterilmiştir. SCORE risk sistemi
ile hesaplanan 10 yıllık fatal KV olay ihtimalinin non-dipper hasta grubunda daha yüksek
saptanması, esansiyel HT tanılı hastaların AKBİ ile takibinin önemini ortaya
çıkarmıştır.
References
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- 12. Dolan E, Stanton A, Thijs L, et al. Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension 2005; 46: 156-61.
- 13. Ingelsson E, Bjorklund-Bodegard K, Lind L, Arnlov J, Sundstrom J. Diurnalbloodpressurepatternand risk of congestiveheartfailure. JAMA 2006; 295: 2859–66.
- 14. Hermida RC, Ayala DE, Ferna´ndez JR, Mojo´n A. Sleep-time blood pressure: Prognostic value and relevance as a therapeutic target for cardiovascular risk reduction. Chronobiol Int 2013; 30: 68–86.
- 15. Kikuya M, Ohkubo T, Asayama K, et al. Ambulatory blood pressure and 10-year risk of cardiovascular and noncardiovascular mortality. The Ohasama Study. Hypertension 2005; 45: 240–25.
- 16. Ben-Dov IZ, Kark JD, 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. Hypertension 2007; 49: 1235–41.
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- 19. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate Glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999; 130: 461-70.
- 20. Schillaci G, Parati G. Determinants of blood pressure variability in youth: at the roots of hypertension. J Hypertens 2010; 28: 660-4.
- 21. Wei FF, Li Y, Zhang L, et al. Association of target organ damage with 24-hour systolic and diastolic blood pressure levels and hypertension subtypes in untreated Chinese. Hypertension 2014; 63: 222-8.
- 22. Portaluppi F, Tiseo R, Smolensky MH, Hermida RC, Ayala DE, Fabbian F. Circadian rhythms and cardiovascular health. Sleep Med Rev 2012; 16: 151–66.
- 23. Staessen JA, Thijs L, Fagard R, et al. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. J Am Med Assoc 1999; 282: 539–46.
- 24. Blood Pressure Lowering Treatment Trialists’ Collaboration. Blood pressure-lowering treatment based on cardiovascular risk: a meta-analysis of individual patient data. Lancet 2014; 384: 591–8.
- 25. de la Sierra A, Redon J, Banegas JR, et al. Spanish Society of Hypertension Ambulatory Blood Pressure Monitoring Registry Investigators. Prevalence and factors associated with circadian blood pressure patterns in hypertensive patients. Hypertension 2009; 53: 466–72.
- 26. Gungor A, Aydın Y, Celbek G, et al. Asymmetric dimethyl arginin elevels in dipper and nondipper hypertensive patients. Dicle Medical Journal 2010; 37: 332-8.
- 27. International Society for Chronobiology; American Association of Medical Chronobiology and Chrono therapeutics; Spanish Society of Applied Chronobiology, Chronotherapy, and Vascular Risk; Spanish Society of Atherosclerosis; Romanian Society of Internal Medicine, Hermida RC, Smolensky MH, Ayala DE, Portaluppi F. 2013 ambulatory blood pressure monitoring recommendations for the diagnosis of adult hypertension, assessment of cardiovascular and other hypertension-associated risk, and attainment of therapeutic goals. Chronobiol Int 2013; 30: 355-410.
- 28. Rymkiewicz E, Rękas-Wójcik A, Bukszyńska-Sołdaj K, Dzida G. Coexistence of non-dipper hypertension with other chronic diseases. Arterial Hypertension 2015; 19: 84-7. 29. Leone A. Evidence of Impaired Night-Response of Blood Pressure in Hypertensive Smokers. An Update. J Cardiol Curr Res 2015; 4: 134.
Year 2018,
Volume: 45 Issue: 4, 379 - 386, 13.12.2018
Abstract
References
- 1. Mancia G, Fagard R, Narkiewicz K, et al. Task Force Members. 2013 ESH/ESC Guidelines for the management of arterial hypertension: theTask Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281-357.
- 2. Murphy SJ, Coughlan CA, Tobin O, et al. Continuation and adherence rates on initially-prescribed intensive secondary prevention therapy after Rapid Access Stroke Prevention (RASP) service assessment. J NeurolSci 2016; 361: 13-8.
- 3. Conen D, Bamberg F. Noninvasive 24-h ambulatory blood pressure and cardiovascular disease: a systematic review and meta-analysis. J Hypertens 2008; 26: 1290–9.
- 4. Boggia J, Li Y, Thijs L, et al. International Database on Ambulatory blood pressure monitoring in relation to Cardiovascular Outcomes (IDACO) investigators. Prognostic accuracy of day versus night ambulatory blood pressure: a cohort study. Lancet 2007; 370: 1219-29.
- 5. Fagard RH, Celis H, Thijs L, et al. Day time and night-time blood pressure as predictors of death and cause-specific cardiovascular events in hypertension. Hypertension 2008; 51: 55–61.
- 6. Seo WS, Oh HS. The circadian rhythms of blood pressure and heart rate in the hypertensive subjects: dippers and non-dippers. Yonsei Med J 2002; 43: 320-8.
- 7. Pickering TG. The clinical significance of diurnal blood pressure variations. Dippers and nondippers. Circulation 1990; 81: 700–2.
- 8. RC, Ayala DE, Mojo´n A, Ferna´ndez JR. Decreasing sleep-time blood pressure determined by ambulatory monitoring reduces cardiovascular risk. J Am Coll Cardiol 2011; 58: 1165–73.
- 9. Verdecchia P, Porcellati C, Schillaci G, et al. Ambulatory blood pressure. An independent predictor of prognosis in essential hypertension. Hypertension 1994; 24: 793-801.
- 10. Kario K, Pickering TG, Matsuo T, Hoshide S, Schwartz JE, Shimada K. Stroke prognosis and abnormal nocturnal blood pressure falls in older hypertensives. Hypertension 2001; 38: 852–7.
- 11. Ohkubo T, Hozawa A, Yamaguchi J, et al. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertens 2002; 20: 2183-9.
- 12. Dolan E, Stanton A, Thijs L, et al. Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension 2005; 46: 156-61.
- 13. Ingelsson E, Bjorklund-Bodegard K, Lind L, Arnlov J, Sundstrom J. Diurnalbloodpressurepatternand risk of congestiveheartfailure. JAMA 2006; 295: 2859–66.
- 14. Hermida RC, Ayala DE, Ferna´ndez JR, Mojo´n A. Sleep-time blood pressure: Prognostic value and relevance as a therapeutic target for cardiovascular risk reduction. Chronobiol Int 2013; 30: 68–86.
- 15. Kikuya M, Ohkubo T, Asayama K, et al. Ambulatory blood pressure and 10-year risk of cardiovascular and noncardiovascular mortality. The Ohasama Study. Hypertension 2005; 45: 240–25.
- 16. Ben-Dov IZ, Kark JD, 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. Hypertension 2007; 49: 1235–41.
- 17. Piepoli MF, Hoes AW, Agewall S, et al. ESC Scientific Document Group. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention&Rehabilitation (EACPR). EurHeart J 2016; 37: 2315-81.
- 18. Conroy RM, Pyörälä K, Fitzgerald AP, et al. SCORE Project group. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003; 24: 987-1003.
- 19. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate Glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999; 130: 461-70.
- 20. Schillaci G, Parati G. Determinants of blood pressure variability in youth: at the roots of hypertension. J Hypertens 2010; 28: 660-4.
- 21. Wei FF, Li Y, Zhang L, et al. Association of target organ damage with 24-hour systolic and diastolic blood pressure levels and hypertension subtypes in untreated Chinese. Hypertension 2014; 63: 222-8.
- 22. Portaluppi F, Tiseo R, Smolensky MH, Hermida RC, Ayala DE, Fabbian F. Circadian rhythms and cardiovascular health. Sleep Med Rev 2012; 16: 151–66.
- 23. Staessen JA, Thijs L, Fagard R, et al. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. J Am Med Assoc 1999; 282: 539–46.
- 24. Blood Pressure Lowering Treatment Trialists’ Collaboration. Blood pressure-lowering treatment based on cardiovascular risk: a meta-analysis of individual patient data. Lancet 2014; 384: 591–8.
- 25. de la Sierra A, Redon J, Banegas JR, et al. Spanish Society of Hypertension Ambulatory Blood Pressure Monitoring Registry Investigators. Prevalence and factors associated with circadian blood pressure patterns in hypertensive patients. Hypertension 2009; 53: 466–72.
- 26. Gungor A, Aydın Y, Celbek G, et al. Asymmetric dimethyl arginin elevels in dipper and nondipper hypertensive patients. Dicle Medical Journal 2010; 37: 332-8.
- 27. International Society for Chronobiology; American Association of Medical Chronobiology and Chrono therapeutics; Spanish Society of Applied Chronobiology, Chronotherapy, and Vascular Risk; Spanish Society of Atherosclerosis; Romanian Society of Internal Medicine, Hermida RC, Smolensky MH, Ayala DE, Portaluppi F. 2013 ambulatory blood pressure monitoring recommendations for the diagnosis of adult hypertension, assessment of cardiovascular and other hypertension-associated risk, and attainment of therapeutic goals. Chronobiol Int 2013; 30: 355-410.
- 28. Rymkiewicz E, Rękas-Wójcik A, Bukszyńska-Sołdaj K, Dzida G. Coexistence of non-dipper hypertension with other chronic diseases. Arterial Hypertension 2015; 19: 84-7. 29. Leone A. Evidence of Impaired Night-Response of Blood Pressure in Hypertensive Smokers. An Update. J Cardiol Curr Res 2015; 4: 134.
There are 28 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Research Articles |
| Authors | |
| Publication Date | December 13, 2018 |
| Submission Date | December 15, 2018 |
| Published in Issue | Year 2018 Volume: 45 Issue: 4 |