40 research outputs found
Association between different measurements of blood pressure variability by ABP monitoring and ankle-brachial index
<p>Abstract</p> <p>Background</p> <p>Blood pressure (BP) variability has been associated with cardiovascular outcomes, but there is no consensus about the more effective method to measure it by ambulatory blood pressure monitoring (ABPM). We evaluated the association between three different methods to estimate BP variability by ABPM and the ankle brachial index (ABI).</p> <p>Methods and Results</p> <p>In a cross-sectional study of patients with hypertension, BP variability was estimated by the time rate index (the first derivative of SBP over time), standard deviation (SD) of 24-hour SBP; and coefficient of variability of 24-hour SBP. ABI was measured with a doppler probe. The sample included 425 patients with a mean age of 57 ± 12 years, being 69.2% women, 26.1% current smokers and 22.1% diabetics. Abnormal ABI (≤ 0.90 or ≥ 1.40) was present in 58 patients. The time rate index was 0.516 ± 0.146 mmHg/min in patients with abnormal ABI versus 0.476 ± 0.124 mmHg/min in patients with normal ABI (P = 0.007). In a logistic regression model the time rate index was associated with ABI, regardless of age (OR = 6.9, 95% CI = 1.1- 42.1; P = 0.04). In a multiple linear regression model, adjusting for age, SBP and diabetes, the time rate index was strongly associated with ABI (P < 0.01). None of the other indexes of BP variability were associated with ABI in univariate and multivariate analyses.</p> <p>Conclusion</p> <p>Time rate index is a sensible method to measure BP variability by ABPM. Its performance for risk stratification of patients with hypertension should be explored in longitudinal studies.</p
Cognitive and autonomic dysfunction measures in normal controls, white coat and borderline hypertension
<p>Abstract</p> <p>Background</p> <p>White coat hypertension (WCHT) is a significant clinical condition with haemodynamic differences and presence of functional changes. We aim to compare cognitive and autonomic dysfunction variables (heart rate variability) between subjects with normal blood pressure (controls), WCHT, and borderline hypertension (BLH).</p> <p>Methods</p> <p>We performed a cross-sectional study in a cohort of 69 subjects (mean age ± SD; 38.2 ±10.8 years) comprising comparable number of normal controls, WCHT, and BLH. We measured clinic and 24-hour ambulatory blood pressure monitoring (ABPM), cognitive function parameters, and heart rate variability (HRV). All subjects underwent 24-hour ambulatory electrocardiography monitoring which was analyzed for HRV measurements. We performed a routine echocardiography (ECHO) for all subjects.</p> <p>Results</p> <p>Multiple comparison between the three groups revealed significant (p < 0.04) differences in mean day-time ABPM (systolic and diastolic). In the state anxiety inventory (SAI), both subjects with WCHT and BLH had significantly (p < 0.006) higher anxiety levels than the control group. In memory tasks WCHT subjects scored significantly (p < 0.004) lower in comparison with the other two groups. WCHT significantly (p < 0.001) performed less in memory tests, whereas BLH subjects had significantly (p < 0.001) lower reaction time. We found a significant (p < 0.05) difference in the 24-hour RMSSD and SDNN between the three groups. There was significant correlation between 24-hour RMSSD and computer CANTAB scores. The Echocardiography assessment revealed no significant differences in LV mass indices and diastolic function.</p> <p>Conclusions</p> <p>WCHT and BLH subjects showed lower cognitive performance and higher levels of anxiety when compared to controls. Autonomic function reflected by HRV indices was lower in WCHT and BLH in contrast to control, though not significantly. Our results suggest that WCHT may not be a benign condition as it may contribute to the overall risk for cardiovascular disease and LV damage. Longitudinal studies of patients with WCHT should clarify the transient, persistent or the progressive nature of this condition.</p
Impact of cardiac transplantation in 24 hours circadian blood pressure and heart rate profile
Objective. The aim of the present study was to evaluate 24 hours blood
pressure (BP) and heart rate changes as well as 24-hour circadian BP
rhythm of cardiac transplant recipients.
Methods. Twenty-five transplant recipients and twenty-five healthy
volunteers underwent 24-hour ambulatory BP monitoring. Parameters of
24-hour ambulatory BP monitoring (24-h/daytime/nightime systolic,
diastolic BP, pulse pressure, and heart rate) were determined in all
patients.
Results. Clinic systolic/diastolic BP, mean 24-h systolic/diastolic BP,
mean daytime systolic/diastolic BP, mean nighttime systolic/diastolic
BP, and mean 24-h/daytime/nighttime heart rate were significantly higher
in transplant recipients than in control group subjects. Standard
deviations of 24-h/daytime/nighttime heart rates were significantly
lower in transplant recipients. Dippers were 48% of the control and
only 12% of the transplantation group.
Conclusions. Cardiac transplant recipients had increased ambulatory BP.
They also had increased 24-h/daytime/nighttime heart rate and decreased
heart rate variability. Also, diminished nocturnal decrease of BP was
found in transplant recipients
Two-peak temporal distribution of stroke onset in Greek patients - A hospital-based study
A circadian distribution with a single peak of stroke onset in the
morning hours has been described in various countries. Analysis of the
temporal pattern of symptom onset in a series of 1,253 Greek first-ever
stroke patients revealed a circadian distribution with two incidence
peaks between 08.00 and 10.00 h, and between 16.00 and 18.00 h.
Considering the different etiopathogenic types of stroke, the same
two-peak time pattern was evaluated in all stroke subgroups with the
only exception of lacunar stroke, which seems to predominantly occur
during night and sleep. A secondary stroke onset peak in the late
afternoon has not been previously described in such detail. A relation
between the second, however lower, frequency peak and the traditional
Greek habit of afternoon sleep (siesta) could be assumed and deserves
further investigation. Copyright (C) 2003 S. Karger AG, Basel
Carotid artery intima-media thickness could predict the presence of coronary artery lesions
The purpose of the present study was to examine whether intima-media
thickness (IMT) predicts the presence of the coronary artery lesions
independent of other risk factors including clinic blood pressure (BP),
parameters of 24-h ambulatory BP monitoring, body mass index, serum
cholesterol. and glucose levels.
The study population consisted of 390 consecutive subjects who had
recently under-one coronary arteriography; 51 subjects with no
measurable lesions in their coronary arteries (control group) and 339
subjects with coronary artery lesions (coronary artery disease [CAD]
group). Mean IMT of the common carotid artery (MCCA) and internal
carotid artery (MICA) were significantly higher in subjects with CAD
compare control subjects (P <.0001). Carotid IMT could predict the
presence of coronary artery lesions independently of clinic or
ambulatory BP values, BMI, serum cholesterol, and glucose levels (P
<.01). Carotid IMT predicted the presence of significant coronary artery
lesions with cutoff values 0.85 and 0.80 for MICA and MCCA,
respectively. The IMT Could be a clinical useful test for the presence
of significant coronary artery lesions. (c) 2005 American Journal of
Hypertension, Ltd
Increased prevalence of Chlamydophila pneumoniae but not Epstein-Barr antibodies in essential hypertensives
Conflicting data exist regarding the relationship between Chlamydophila
pneunoniae (C. pneumoniae) and hypertension. In this study, both C.
pneumoniae IgG and IgA titres and Epstein-Barr virus antibody levels
were measured in 146 sustained hypertensives defined by 24 h ambulatory
blood pressure monitoring (ABPM) and 54 normotensives. C. pneumoniae
antibodies were measured by microimmunofluorescence test. IgG greater
than or equal to 80 and IgA greater than or equal to 40 were defined as
elevated antibody titres. Epstein-Barr antibodies were measured in order
to investigate whether a possible association exists between
hypertension and other, similarly widespread in the general population,
intracellular microorganisms. All participants underwent casual blood
pressure (BP) readings and 24 h ABPM. Subjects having mean 24 h
systolic/diastolic ambulatory BP > 125/80 mmHg, with or without anti
hypertensive medication were defined as hypertensives. Controls were
free of any history or clinical evidence of hypertension, cardiovascular
or pulmonary disease. Of the total participants, 77 hypertensives
(52.7%) and 10 normotensives (18.5%) had IgA titres greater than or
equal to 40 (crosstabs P < 0.000), whereas 76 hypertensives (52.1%) and
15 normotensives (27.8%) had IgG titres greater than or equal to 80,
(crosstabs P < 0.002). No difference was found in Epstein-Barr
antibodies, between hypertensives and normotensives. In conclusion, C.
pneumoniae, but not Epstein-Barr, antibody levels were found
significantly higher in sustained hypertensives, suggesting high
frequency of chronic C. pneumoniae, infections in this specific group of
patients