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Prognostic significance of dipping in older hypertensive patients

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BENDZALA Matej KRUZLIAK Peter GASPAR Ludovit SOUČEK Miroslav MRDOVIC Igor SABAKA Peter DUKAT Andrej GASPAROVA Iveta MALAN Leoné TAKAZAWA Kenji

Rok publikování 2015
Druh Článek v odborném periodiku
Časopis / Zdroj Blood Pressure
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Doi http://dx.doi.org/10.3109/08037051.2014.992198
Obor Kardiovaskulární nemoci včetně kardiochirurgie
Klíčová slova 5-year mortality; ABPM; arterial hypertension; blood pressure dipping
Popis Abstract Background and aims. Arterial hypertension doubles the risk of coronary heart disease, heart and kidney failure, and peripheral arterial disease. Less variation in diurnal ambulatory blood pressure monitoring (ABPM) patterns may affect mortality outcome. Therefore, as hypertension occurs in over 95% of older subjects, the prognostic value of dipping status in older hypertensive patients will be assessed. Method. The retrospective study group consisted of 170 hypertensive patients, aged 75-84 years, enrolled in the years 2005 to 2007. Baseline measures included 24-h ABPM. Diurnal index and dipping status was calculated and stratified the group into dippers (40 patients, 23.5%), non-dippers (65 patients, 38.2%) and reverse-dippers (65 patients, 38.2%). Results. During a 5-year observation, after baseline we have observed 69 deaths (40.9%) from the whole group of 170 patients with 23 (35.4%) being non-dippers and 36 (55.4%) reverse-dippers. There were significant differences between the groups divided according to diurnal dipping status in survival time, number of recorded deaths and night mean blood pressure. We have identified and confirmed risk factors for the all-cause mortality: age, mean systolic and diastolic blood pressure, diurnal index and dipping status (dipping, non-dipping or reverse-dipping). Conclusion. Reverse-dippers and non-dippers revealed worse prognosis compared with dippers.

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