Objective:Evaluation of short-term blood pressure (BP) variability and its associations with blood pressure measurements, in the different periods nalysed by Ambulatory Blood Pressure Monitoring (ABPM), in hypertensive patients with or without diabetes.Design and method:Analytical cross-sectional study, developed with a database containing 25-year historical series (1993 - 2018) of ABPM exams; diabetes is considered as comorbidity for hypertension. Variables nalysed: Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) of 24 h, daytime and nighttime; Standard deviation; coefficient of variation SBP and DBP, nocturnal drop, age and body mass index. Accomplished logistic regression analysis, Confidence Interval of 95% and 5% of significance level.Results:Analyzed 1591 exams, identified 281 (17.7%) as diabetic hypertensives. Diabetics were older, (63.0; ± 10.9) than non-diabetics 57.7 (±13.9) and also had higher body mass index (28.9; ± 5.0 - 26.7; ± 4.4); with similar gender distribution. A higher proportion of uncontrolled nocturnal BP was identified among diabetics with 77.5% and 68.1% among non-diabetics. In the multivariate logistic regression analysis, considering in the model the presence or absence of DM as the dependent variable, the associated predictor variables were age (OR 1.04; 95% CI 1.01 - 1.08); media DBP in wakefulness (OR 1.34; IC95% 1.04 - 1.85), IMC (obese/non obese) (OR 2.35; 95%CI 1.18 - 4.66). The Coefficients of variation of blood pressure, systolic or diastolic, showed no significant association with the presence of DM morbidity along with HA. Analysis of the medium Coefficient of Variation of Systolic Blood Pressure showed decreasing measures in 24 hours, daytime, nighttime, similarly between diabetics and non-diabetics. A total of 229 (83.3%) no dipper diabetics and 973 (74.5%) of non-diabetics were identified. (p = 0,002). Diabetics had significantly lower control rate than non-diabetics in the 24-hour period and during nigttime.Conclusions:It was identified that diabetic hypertensives were older, had lower blood pressure control during the nighttime period, with a lower proportion of non-dippers and were more obese. The pressure variation coefficients showed the same pattern between diabetics and non-diabetics.
Objective:To describe patterns of short-term blood pressure variability and the association with age.Design and method:Cross-sectional study, with series of exams executed during 25 years. Variables used: gender, age, blood pressure values in different periods, nocturnal drop, coefficient of variation (CV) and standard deviation; normal nocturnal drop between 10% and 20% of blood pressure reduction, media of 24 hours CV-PAS was used for cutoff point. Effect sizes were calculated for differences in means – of Cohen, performed ANCOVA in all ABPM periods using the covariate sex; significance level for all nalyses 5%.Results:Analyzed 2073 exams, 66.3% of the female sex; medium age 58.3 years (±12.6), 29.4% were older than 65 years. The elderly, in all periods, had higher SBP media and lower of DBP. The elderly showed less BP control during nighttime (27.3%) than adults (35.3%) and more absence of nighttime drop (83.5%). Nocturnal drop in elderly was 17.7%/systolic and 36.6%/diastolic; in adults was 26.8%/52.1%, respectively. The Systolic Coefficient of Variation was higher among elderly in the 24hr period 10.8 (±3.1) x 10.0 (±2.4), daytime 10.3 (±2.9) x 9.0 (±2.4) and nighttime 9.0 (±3.0) x 8.6 (±2.8).Conclusions:The elderly had less pressure control during sleep and more absence of nocturnal drop; furthermore, they had a higher Systolic Coefficient of Variation in all periods.
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