Descenso nocturno de la presión arterial: factores determinantes y relación con daño orgánico secundario a hipertensión

In a sample comprising 51 normotensive subjects and 51 subjects with in-clinic arterial hypertension [blood pressures (BPs) > or = 140/90 mmHg), we investigated the prevalence of target organ damage [left ventricular hypertrophy (LVH) and retinal vasculopathy] in white coat hypertension (WCH) groups defined using: (a) the "optimal ambulatory BP" criterion of the Seventh International Consensus Conference (in-clinic BPs >140/90 mmHg, daytime mean BPs < 130/80 mmHg) and (b) the "normal ambulatory BP" criterion proposed in 1997 by Verdecchia and co-workers (in-clinic BPs >140/ 90 mmHg, daytime mean BPs < 135/85 mmHg), and we compared the results with those obtained for the normotensive group and for a WCH group defined as in a 1996 study of the same data. We found that the newer criteria did not alter the conclusions reached in 1996: namely, that WCH constitutes a state of risk intermediate between normotension and sustained hypertension, which demands in-depth evaluation and active monitoring, if not immediate therapy. We also found that when the WCH group was defined as those patients with in-clinic BPs > or = 140/90 mmHg and 24-h mean BPs < 121/78 mmHg, the prevalence of target organ damage was similar to that found in the control group. We conclude that if WCH status is to imply absence of elevated risk of target organ damage, then the ambulatory BP threshold defining WCH should be lower than the upper limit of ambulatory BPs among subjects who are normotensive in the clinic. The desirability of predicting target organ damage in both hypertensive and normotensive subjects using criteria combining in-clinic BPs, daytime mean ambulatory BPs and night-time mean ambulatory BPs is suggested.

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Investigación en atención primaria: la experiencia del grupo MAPA-MADRID (1993-2005)

García-Puig

Martínez-López

Vázquez-Rodríguez

2006

Medicina Clínica

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Descenso nocturno de la presión arterial: factores determinantes y relación con daño orgánico secundario a hipertensión

Abstract: Relative night-time drop in blood pressure is greater in women than in men, diminishes with age and depends on the day-time ambulatory pressure. In women a minor night-time drop in blood pressure is associated with greater organic damage.

Cited by 3 publications

References 35 publications

Colaboración entre hospital y Atención Primaria en el área cardiovascular: experiencia del grupo MAPA

Colaboración entre hospital y Atención Primaria en el área cardiovascular: experiencia del grupo MAPA

Diagnostic Criteria of White Coat Hypertension (WCH): Consequences for the Implications of WCH for Target Organs

Investigación en atención primaria: la experiencia del grupo MAPA-MADRID (1993-2005)

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