Background Blood pressure variability (BPV) has been shown to predict cardiovascular events. Within‐visit BPV is the simplest and easiest measure of BPV, but previous studies have shown conflicts as to whether within‐visit BPV correlates with target organ damage. We aimed to evaluate whether within‐visit BPV correlates with B‐type natriuretic peptide (BNP) in a general population. Hypothesis Within‐visit BPV correlates with BNP in a general population. Methods This was a cross‐sectional study that included 633 individuals, randomly selected, age 45 to 99 years, registered in the primary care program from an urban medium‐sized town. Patients were scheduled for a single‐day visit that consisted of clinical evaluation and laboratory tests. Three blood pressure (BP) readings, 1 minute apart, were done, and within‐visit BPV was determined as the coefficient of variation (CV) of the 3 BP measures. Our main outcome was to correlate BNP and within‐visit BPV. A multivariable model was estimated using a generalized linear model to evaluate the independent effects of different variables on BNP levels. Results The median age was 57 years. Median BNP was 16 pg/mL, and the median systolic and diastolic BP‐CV were, respectively, 3.9% and 3.5%. There was a weak but positive correlation between BNP and both systolic BP‐CV and diastolic BP‐CV (r = 0.107 and P = 0.007 and r = 0.092 and P = 0.019, respectively). In multiple regression equation, systolic BP, diastolic BP‐CV, body mass index, and estimated glomerular filtration rate were associated with BNP. Conclusions In the present study, there was a positive, albeit weak, correlation between within‐visit BPV and BNP. In addition, diastolic BPV was associated with BNP even after adjustment for multiple confounders.
Background: Obstructive sleep apnea (OSA) is a chronic progressive disorder with high mortality and morbidity rate, associated with cardiovascular diseases (CVD), especially heart failure (HF). The pathophysiological changes related to OSA can directly affect the diastolic function of the left ventricle. Objectives: To assess the association of the risk of OSA, evaluated by the Berlin Questionnaire (BQ), and echocardiographic (ECHO) parameters related to diastolic dysfunction in individuals without HF assisted in primary care. Methods: A cross-sectional study that included 354 individuals (51% women) aged 45 years or older. All individuals selected were submitted to an evaluation that included the following procedures: consultation, filling out the BQ, clinical examination, laboratory examination and transthoracic Doppler echocardiography (TDE). Continuous data are presented as medians and interquartile intervals, and categoric variables in absolute and relative frequencies. The variables associated with risk of OSA and at the 0.05 level integrated the gamma regression models with a log link function. A value of p < 0.05 was considered an indicator of statistical significance. Exclusion criteria were presence of HF, to fill out the BQ and patients with hypertension and obesity not classified as high risk for OSA by other criteria. All individuals were evaluated on a single day with the following procedures: medical appointment, BQ, laboratory tests and ECHO. Results: Of the 354 individuals assessed, 63% were classified as having high risk for OSA. The patients with high risk for OSA present significantly abnormal diastolic function parameters. High risk for OSA confirmed positive and statistically significant association, after adjustments, with indicators of diastolic function, such as indexed left atrium volume LAV-i (p = 0.02); E'/A' (p < 0.01), A (p = 0.02), E/A (p < 0.01). Conclusion: Our data show that patients at high risk for OSA present worsened diastolic function parameters measured by TDE.
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