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NON-DIPPER HYPERTENSION AND BLOOD PRESSURE VARIABILITY IN YOUNG HYPERTENSION PATIENTS

Year 2023, Volume: 24 Issue: 3, 364 - 368, 13.07.2023
https://doi.org/10.18229/kocatepetip.1207644

Abstract

OBJECTIVE: Hypertension is a global health problem that also affects the young population and increases cardiovascular mortality. Young hypertensive patients are more prone to end-organ damage and complications from hypertension due to the long exposure time to high blood pressure. In our study, we aimed to investigate the mean systolic and diastolic blood pressure values of young hypertensive patients compared to hypertensive patients over 40 years of age with 24-hour ambulatory blood pressure measurement, and especially non-dipper hypertension states and blood pressure variability associated with end organ damage.
MATERIAL AND METHODS: The study included 337 patients, 83 of whom were young hypertensive patients. 24-hour ambulatory blood pressure monitoring records of the patients were reviewed retrospectively. The mean systolic and diastolic blood pressure values, dipper and non-dipper hypertension status, and blood pressure variability of the patients were calculated. The results of young hypertensive patients were compared with hypertensive patients aged above 40.
RESULTS: The mean 24-hour diastolic blood pressure was found to be higher in young hypertensive patients than hypertensive patients aged above 40. When both groups were compared according to non-dipper hypertension, non-dipper hypertension was found to be higher in the hypertensive patients group aged above 40. While 24-hour diastolic blood pressure variability was found to be higher in young hypertensive patients, daytime systolic blood pressure variability was found to be higher in the hypertensive patients aged above 40.
CONCLUSIONS: Evaluation of non-dipper blood pressure and blood pressure variability with 24-hour Ambulatory blood pressure monitoring (ABPM) in young hypertension patients may help to identify the patient group at risk for end-organ damage development.

References

  • 1. Williams B, Mancia G, Spiering W et al. ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018:1;39(33):3021-3104.
  • 2. Dastan I, Erem A, Cetinkaya V. Awareness, treatment, control of hypertension, and associated factors: Results from a Turkish national study. Clin Exp Hypertens. 2018;40(1):90-98.
  • 3. Arıcı M, Genç Hipertansif Hasta: Tanı ve Tedavi Yaklaşımları, Türkiye Tıp Dergisi. 2003;10(1):29-35.
  • 4. Kaplan M M, Yürük Yıldırım Z, Yavaş Aksu B ve ark., Çocuklarda Hipertansiyon Etiyolojisi ile Yaşam İçi Kan Basıncı İzlemi Arasındaki İlişki, Çocuk Dergisi. 2018;18(3):121-128.
  • 5. Flynn J, Zhang Y, Solar-Yohay S, Shi V. Clinical and demographic characteristics of children with hypertension. Hypertension. 2012;60(4):1047-54.
  • 6. Verdecchia P, Borgioni C, Ciucci A, et al. Prognostic significance of blood pressure variability in essential hypertension. Blood Press Monit. 1996;1(1):3-11.
  • 7. 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(3):320-8.
  • 8. Parati G, Ochoa JE, Lombardi C, Bilo G. Assessment and management of blood-pressure variability. Nat Rev Cardiol. 2013;10(3):143-55.
  • 9. Conway J, Boon N, Davies C, et al. Neural and humoral mechanisms involved in blood pressure variability. J Hypertens. 1984;2(2):203-8.
  • 10. Verdecchia P, Schillaci G, Porcellati C. Dippers versus non-dippers. J Hypertens Suppl. 1991;9(8):42-4.
  • 11. Hermida RC, Ayala DE, Mojón A, et al. Blunted sleep-time relative blood pressure decline increases cardiovascular risk independent of blood pressure level--the "normotensive non-dipper" paradox. Chronobiol Int. 2013;30(1-2):87-98.
  • 12. Verdecchia P, Angeli F, Reboldi G. Chronic Kidney Disease and Left Ventricular Hypertrophy. Potent Modifiers of the Prognostic Impact of Circadian Blood Pressure Changes. Hypertension. 2022;79(5):1028- 1036.
  • 13. Altun B, Arici M, Nergizoğlu G, et al. Turkish Society of Hypertension and Renal Diseases. Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens. 2005;23(10):1817-23.
  • 14. Ordu S, Ozhan H, Alemdar R, et al. Cystatin C levels in patients with dipper and nondipper hypertension. J Investig Med. 2012;60(4):676-9.
  • 15. Musialik D, Kosicka T, Skołuda A, et al. Twenty-four hour ambulatory blood pressure monitoring in young and elderly hypertensive subjects. J Hum Hypertens.1998;12(9):641-2.
  • 16. Hocht C. Blood pressure variability: prognostic value and therapeutic implications. Hindawi Publishing Coporation ISRN Hypertension. 2013;2013:ID398485–ID398485.
  • 17. Mustafa ER, Istrătoaie O, Mușetescu R. Blood Pressure Variability and Left Ventricular Mass in Hypertensive Patients. Curr Health Sci J. 2016;42(1):47-50.
  • 18. Stevens SL, Wood S, Koshiaris C, Law K, Glasziou P, Stevens RJ, McManus RJ. Blood pressure variability and cardiovascular disease: systematic review and meta-analysis. BMJ. 2016;(9):354.

GENÇ HİPERTANSİYON HASTALARINDA NON-DİPPER HİPERTANSİYON VE KAN BASINCI DEĞİŞKENLİĞİ

Year 2023, Volume: 24 Issue: 3, 364 - 368, 13.07.2023
https://doi.org/10.18229/kocatepetip.1207644

Abstract

AMAÇ: Hipertansiyon, genç popülasyonu da etkileyen ve kardiyovasküler mortaliteyi artıran global bir sağlık sorunudur. Genç hipertansif hastalar, yüksek kan basıncına maruz kaldıkları süre uzun olduğundan uç organ hasarına ve hipertansiyonun neden olduğu komplikasyonlara daha yatkındırlar. Biz çalışmamızda 24 saatlik ambulatuar kan basıncı ölçümü ile genç hipertansif hastaların, 40 yaş üstü hipertansif hastalara göre ortalama sistolik ve diyastolik tansiyon değerlerini ve özellikle uç organ hasarı ile ilişkili olan non-dipper hipertansiyon durumlarını ve kan basıncı değişkenliğini araştırmayı amaçladık.
GEREÇ VE YÖNTEM: Çalışmaya, 83’ü genç hipertansif hasta olmak üzere toplam 337 hasta alındı. Hastaların 24 saatlik tansiyon holter kayıtları retrospektif olarak incelendi. Hastaların ortalama sistolik ve diyastolik tansiyon değerleri, dipper ve non-dipper hipertansiyon durumları ve kan basıncı değişkenliği hesaplandı. Genç hipertansif hastaların sonuçları, 40 yaş üstü hipertansif hastalarla karşılaştırıldı.
BULGULAR: Genç hipertansif hastaların, 24 saatlik diyastolik tansiyon ortalamaları 40 yaş üstü hipertansif hastalara göre daha yüksek saptandı. Non-dipper hipertansiyon olma durumuna göre her iki grup karşılaştırıldığında, 40 yaş üstü hipertansiyon grubunda non-dipper hipertansiyon olma durumu daha yüksek bulundu. 24 saatlik diyastolik tansiyon değişkenliği, genç hipertansif hastalarda daha yüksek saptanırken, gündüz sistolik kan basıncı değişkenliği, 40 yaş üstü hipertansif hastalarda daha yüksek bulundu.
SONUÇ: Genç hipertansiyon hastalarında, 24 saatlik Ambulatuar kan basıncı ölçümü (ABPM) ile non-dipper tansiyon olma durumu ve kan basıncı değişkenliğinin değerlendirilmesi uç organ hasarı gelişimi yönünden riskli hasta grubunu belirlemede yardımcı olabilir.

References

  • 1. Williams B, Mancia G, Spiering W et al. ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018:1;39(33):3021-3104.
  • 2. Dastan I, Erem A, Cetinkaya V. Awareness, treatment, control of hypertension, and associated factors: Results from a Turkish national study. Clin Exp Hypertens. 2018;40(1):90-98.
  • 3. Arıcı M, Genç Hipertansif Hasta: Tanı ve Tedavi Yaklaşımları, Türkiye Tıp Dergisi. 2003;10(1):29-35.
  • 4. Kaplan M M, Yürük Yıldırım Z, Yavaş Aksu B ve ark., Çocuklarda Hipertansiyon Etiyolojisi ile Yaşam İçi Kan Basıncı İzlemi Arasındaki İlişki, Çocuk Dergisi. 2018;18(3):121-128.
  • 5. Flynn J, Zhang Y, Solar-Yohay S, Shi V. Clinical and demographic characteristics of children with hypertension. Hypertension. 2012;60(4):1047-54.
  • 6. Verdecchia P, Borgioni C, Ciucci A, et al. Prognostic significance of blood pressure variability in essential hypertension. Blood Press Monit. 1996;1(1):3-11.
  • 7. 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(3):320-8.
  • 8. Parati G, Ochoa JE, Lombardi C, Bilo G. Assessment and management of blood-pressure variability. Nat Rev Cardiol. 2013;10(3):143-55.
  • 9. Conway J, Boon N, Davies C, et al. Neural and humoral mechanisms involved in blood pressure variability. J Hypertens. 1984;2(2):203-8.
  • 10. Verdecchia P, Schillaci G, Porcellati C. Dippers versus non-dippers. J Hypertens Suppl. 1991;9(8):42-4.
  • 11. Hermida RC, Ayala DE, Mojón A, et al. Blunted sleep-time relative blood pressure decline increases cardiovascular risk independent of blood pressure level--the "normotensive non-dipper" paradox. Chronobiol Int. 2013;30(1-2):87-98.
  • 12. Verdecchia P, Angeli F, Reboldi G. Chronic Kidney Disease and Left Ventricular Hypertrophy. Potent Modifiers of the Prognostic Impact of Circadian Blood Pressure Changes. Hypertension. 2022;79(5):1028- 1036.
  • 13. Altun B, Arici M, Nergizoğlu G, et al. Turkish Society of Hypertension and Renal Diseases. Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens. 2005;23(10):1817-23.
  • 14. Ordu S, Ozhan H, Alemdar R, et al. Cystatin C levels in patients with dipper and nondipper hypertension. J Investig Med. 2012;60(4):676-9.
  • 15. Musialik D, Kosicka T, Skołuda A, et al. Twenty-four hour ambulatory blood pressure monitoring in young and elderly hypertensive subjects. J Hum Hypertens.1998;12(9):641-2.
  • 16. Hocht C. Blood pressure variability: prognostic value and therapeutic implications. Hindawi Publishing Coporation ISRN Hypertension. 2013;2013:ID398485–ID398485.
  • 17. Mustafa ER, Istrătoaie O, Mușetescu R. Blood Pressure Variability and Left Ventricular Mass in Hypertensive Patients. Curr Health Sci J. 2016;42(1):47-50.
  • 18. Stevens SL, Wood S, Koshiaris C, Law K, Glasziou P, Stevens RJ, McManus RJ. Blood pressure variability and cardiovascular disease: systematic review and meta-analysis. BMJ. 2016;(9):354.
There are 18 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Articles
Authors

Serkan Gökaslan 0000-0001-7268-178X

İbrahim Etem Dural 0000-0003-4005-4858

Ömer Faruk Yılmaz 0000-0002-0055-8341

Publication Date July 13, 2023
Acceptance Date December 12, 2022
Published in Issue Year 2023 Volume: 24 Issue: 3

Cite

APA Gökaslan, S., Dural, İ. E., & Yılmaz, Ö. F. (2023). GENÇ HİPERTANSİYON HASTALARINDA NON-DİPPER HİPERTANSİYON VE KAN BASINCI DEĞİŞKENLİĞİ. Kocatepe Tıp Dergisi, 24(3), 364-368. https://doi.org/10.18229/kocatepetip.1207644
AMA Gökaslan S, Dural İE, Yılmaz ÖF. GENÇ HİPERTANSİYON HASTALARINDA NON-DİPPER HİPERTANSİYON VE KAN BASINCI DEĞİŞKENLİĞİ. KTD. July 2023;24(3):364-368. doi:10.18229/kocatepetip.1207644
Chicago Gökaslan, Serkan, İbrahim Etem Dural, and Ömer Faruk Yılmaz. “GENÇ HİPERTANSİYON HASTALARINDA NON-DİPPER HİPERTANSİYON VE KAN BASINCI DEĞİŞKENLİĞİ”. Kocatepe Tıp Dergisi 24, no. 3 (July 2023): 364-68. https://doi.org/10.18229/kocatepetip.1207644.
EndNote Gökaslan S, Dural İE, Yılmaz ÖF (July 1, 2023) GENÇ HİPERTANSİYON HASTALARINDA NON-DİPPER HİPERTANSİYON VE KAN BASINCI DEĞİŞKENLİĞİ. Kocatepe Tıp Dergisi 24 3 364–368.
IEEE S. Gökaslan, İ. E. Dural, and Ö. F. Yılmaz, “GENÇ HİPERTANSİYON HASTALARINDA NON-DİPPER HİPERTANSİYON VE KAN BASINCI DEĞİŞKENLİĞİ”, KTD, vol. 24, no. 3, pp. 364–368, 2023, doi: 10.18229/kocatepetip.1207644.
ISNAD Gökaslan, Serkan et al. “GENÇ HİPERTANSİYON HASTALARINDA NON-DİPPER HİPERTANSİYON VE KAN BASINCI DEĞİŞKENLİĞİ”. Kocatepe Tıp Dergisi 24/3 (July 2023), 364-368. https://doi.org/10.18229/kocatepetip.1207644.
JAMA Gökaslan S, Dural İE, Yılmaz ÖF. GENÇ HİPERTANSİYON HASTALARINDA NON-DİPPER HİPERTANSİYON VE KAN BASINCI DEĞİŞKENLİĞİ. KTD. 2023;24:364–368.
MLA Gökaslan, Serkan et al. “GENÇ HİPERTANSİYON HASTALARINDA NON-DİPPER HİPERTANSİYON VE KAN BASINCI DEĞİŞKENLİĞİ”. Kocatepe Tıp Dergisi, vol. 24, no. 3, 2023, pp. 364-8, doi:10.18229/kocatepetip.1207644.
Vancouver Gökaslan S, Dural İE, Yılmaz ÖF. GENÇ HİPERTANSİYON HASTALARINDA NON-DİPPER HİPERTANSİYON VE KAN BASINCI DEĞİŞKENLİĞİ. KTD. 2023;24(3):364-8.

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