Ausência de descenso noturno se associa a acidente vascular cerebral e infarto do miocárdio

Vaz-de-Melo, Renan Oliveira; Loureiro, Afonso Augusto Carvalho; Cipullo, José Paulo; Júnior, Heitor Moreno; Martin, José Fernando Vilela

doi:10.1590/s0066-782x2010000100013

Cited by 12 publications

(12 citation statements)

References 37 publications

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“…In another study which was designed to investigate the hypertensive target organ damage difference between the dippers and non-dippers, left ventricular mass indexes were found to be significantly greater in patients with non-dipping BP profiles [21]. From the clinical point of view, the prevalence of the most undesirable consequences of atherosclerotic burden such as stroke and myocardial infarction were disclosed to be high in the absence of nocturnal dipping in BP [22]. Despite the presence of many reports evaluating the association between non-dipper hypertension and atherosclerosis/atherosclerosis-related diseases, few efforts have been made to investigate the underlying mechanisms so far.…”

Section: Discussionmentioning

confidence: 99%

Red Blood Cell Distribution Width in ‘Non-Dippers’ versus ‘Dippers’

et al. 2012

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Objectives: Because both high red cell distribution width (RDW) and non-dipping hypertension are closely related to adverse cardiovascular outcomes and higher inflammatory status, we aimed to investigate whether there is any relationship between RDW and dipping/non-dipping hypertension status. Methods: The present study involved 123 hypertensive patients and 65 age- and gender-matched healthy, normotensive subjects. Hypertensive patients were divided into two groups: 56 dipper patients (20 males, mean age 51.9 ± 15.3 years) and 67 non-dipper patients (27 males, mean age 55.6 ± 15.0 years). If the systolic daytime blood pressure (BP) of the patients decreased by at least 10% during the nighttime, these subjects were ‘dippers’, and all other subjects were ‘non-dippers’. Results: Both dipper patients and non-dipper patients had higher levels of RDW compared to normotensives (13.5 ± 0.89 and 14.1 ± 1.33 vs. 13.0 ± 1.42%, p = 0.027 and p <0.001, respectively). Also RDW values in non-dippers were statistically higher compared to those in dippers (p = 0.008). Although there were negative correlations between RDW values and nocturnal systolic BP fall (p = 0.027, r = –0.199) and diastolic BP fall (p = 0.383, r = –0.079) in all hypertensive patients, these correlations did not reach a statistically significant level. Conclusion: Our study demonstrates that non-dippers have high RDW levels compared to both dippers and controls.

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Section: Discussionmentioning

confidence: 99%

Red Blood Cell Distribution Width in ‘Non-Dippers’ versus ‘Dippers’

et al. 2012

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“…A nocturnal dip (ND) was defined as a decrease in BP ≥ 10% from awake to sleep. 14 A WCE was considered present when an individual had a BP outside the control target when measured at the office, but a normal ABPM. However, if the BP was controlled in the office but elevated during the ABPM, the patient was classified as having a false control.…”

Section: Methodsmentioning

confidence: 99%

Blood Pressure Treatment Adherence and Control after Participation in the ReHOT

Jesus¹,

Nogueira²,

Pachu³

et al. 2016

Arquivos Brasileiros De Cardiologia

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BackgroundLack of adherence to pharmacological treatment is one of the main causes of low control rates in hypertension.ObjectiveTo verify treatment adherence and associated factors, as well as blood pressure (BP) control in participants of the Resistant Hypertension Optimal Treatment (ReHOT) clinical trial.MethodCross-sectional study including all 109 patients who had completed the ReHOT for at least 6 months. We excluded those participants who failed to respond to the new recruitment after three phone contact attempts. We evaluated the BP control by ambulatory BP monitoring (ABPM; controlled levels: 24-hour systolic and diastolic BP < 130 x 80 mmHg) and analyzed the patients' treatment adherence using the Morisky Medication Adherence Scale (MMAS) questionnaire validated by Bloch, Melo, and Nogueira (2008). The statistical analysis was performed with the software IBM SPSS statistics 21.0. We tested the normality of the data distribution with kurtosis and skewness. The variables tested in the study are presented with descriptive statistics. Comparisons between treatment adherence and other variables were performed with Student's t test for independent variables and Pearson's chi-square or Fisher's exact test. To conduct analyses among patients considering adherence to treatment and BP control, we created four groups: G0, G1, G2, and G3. We considered a 5% significance level in all tests.ResultsDuring the ReHOT, 80% of the patients had good BP control and treatment adherence. Of 96 patients reevaluated in the present study, only 52.1% had controlled hypertension when assessed by ABPM, while 31.3% were considered adherent by the MMAS. Regarding other ABPM measures, we observed an absence of a nocturnal dip in 64.6% of the patients and a white-coat effect and false BP control in 23% and 12.5%, respectively. Patients' education level showed a trend towards being a determinant factor associated with lack of adherence (p = 0.05). Resistant hypertension and number of medications were significantly associated with BP control assessed by ABPM (p = 0.009 and p = 0.001, respectively). Resistant hypertension was also significantly associated with group G0 (patients with no control or adherence, p = 0.012).ConclusionThere was a decrease in BP control and adherence measured by the MMAS after participation of at least 6 months in the ReHOT clinical trial.

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“…Most studies have assessed BP levels with a single office BP measurement or even reported BP medication. Only a few studies have utilized ambulatory blood pressure monitoring, which presents better correlation with daily life blood pressure and hypertension-related target organ damage [10, 68]. …”

Section: Limitations Involved In This Associationmentioning

confidence: 99%

Is There an Association between Periodontitis and Hypertension?

Paizan¹,

Vilela-Martin²

2014

CCR

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Cardiovascular diseases are the leading cause of deaths. Also, cardiovascular risk factors start the atherosclerotic process, which leads to cardiovascular diseases. Nowadays, periodontal disease can also be considered another cardiovascular risk factor. It involves inflammatory, immunological and humoral activities, which induce the production of proinflammatory cytokines and the destruction of the epithelium. This allows the entry of endotoxins and exotoxins in the bloodstream, which may contribute to atherogenesis and thromboembolic events. There is also direct invasion of the vessel wall by oral pathogens, triggering an inflammatory response that produces endothelial dysfunction. In hypertension, changes in microcirculation can cause ischemia in the periodontium, which favors periodontal disease. Moreover, endothelial dysfunction promotes the formation of atherosclerotic plaque and the development of lesions in target organs. Periodontitis has also been associated with insulin resistance and a higher risk for the metabolic syndrome, which is characterized by oxidative stress. This seems to act as a common link to explain the relationship between each component of the metabolic syndrome (including hypertension) and periodontitis. This article will discuss clinical and experimental evidence, as well as possible pathophysiologic mechanisms and links involved in the relationship among periodontal disease, hypertension and cardiovascular disease.

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Ausência de descenso noturno se associa a acidente vascular cerebral e infarto do miocárdio

Abstract: Background: The arterial hypertension varies in according to the circadian cycle, presenting physiologic fall of blood pressure (BP) during sleep (dipping). The absence of this fall or its increase associates to higher incidence of targetorgan damages.

Cited by 12 publications

References 37 publications

Red Blood Cell Distribution Width in ‘Non-Dippers’ versus ‘Dippers’

Red Blood Cell Distribution Width in ‘Non-Dippers’ versus ‘Dippers’

Blood Pressure Treatment Adherence and Control after Participation in the ReHOT

Is There an Association between Periodontitis and Hypertension?

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