Open AccessBlood pressure variability parameters in essential hypertension and vascular damage
Author(s) -
Asist Univ,
Suzana Guberna,
N. Avram,
Liliana Cătălina,
Crina Andrei
Publication year - 2016
Publication title -
romanian medical journal
Language(s) - English
Resource type - Journals
eISSN - 2069-606X
pISSN - 1220-5478
DOI - 10.37897/rmj.2016.4.12
Subject(s) - medicine , blood pressure , cardiology , quartile , pulse wave velocity , diastole , creatinine , uric acid , dipper , family history , pulse pressure , ambulatory blood pressure , endocrinology , confidence interval
The idea that the degree of hypertension (HT) is a predictor of end organ damage and has a prognostic value is widespread and well established, but the assumption that BP variability (BPV) has the same relevance is new. The purpose of this study was to analyze the relationship between BPV determined using ABPM and arterial stifness measured using pulse wave velocity (PWV) in a group of patients with newly diagnosed HT starting from the hypothesis that there is a correlation between vascular damage and BPV. The study enrolled 60 subjects with newly diagnosed and untreated hypertension. The evaluation included medical history, demographics, lifestyle, family history (FH) of hypertension, physical examination, current chronic treatments. All subjects underwent ABPM and blood tests (serum creatinine, total cholesterol, blood glucose and uric acid). We calculated: standard deviation (SD), coefficient of variation (CV), excursion (E) for SBP (s), DBP (d), daytime SBP and daytime DBP, nocturnal SBP and nocturnal DBP. The patients were divided into quartiles of systolic BPV, diastolic BPV, diurnal and nocturnal systolic and diastolic BPV. Results: The mean age of patients was 60.56 +/- 6.76 years; 43.33% of patients were male; 66.66% had FH of HT. The average value of seric cholesterol was 186.8 +/- 45.20 mg / dl; the average value of creatinine was 1.08 +/- 0.21 mg/dl, the average value of uric acid was 5.14 +/- 1.33 mg / dl. The average value of PWV was 89.48 +/- 4.66 cm/s. PWV was statistically significant different between SD quartiles of systolic BP at night, coefficient of variation quartiles of systolic BP at night and nocturnal systolic BPV. Also, PWV was different between E quartiles and CV quartiles of systolic BP. In linear regression, statistical significance was obtained for total cholesterol, E of nocturnal SBP, CV of nocturnal SBP and systolic BPV. In multiple linear regression obtained after excluding the independent variables with high collinearity (CV of nocturnal SBP) we achieved statistical significance for high level of seric cholesterol and nocturnal systolic BPV. The data obtained came to strengthen the data in the literature, that an increased value of seric cholesterol is a major determinant of arterial stiffness.