Elevated asleep BP as predictor of type 2 diabetes and therapeutic target for prevention

Hermida, Ramón C.; Ayala, Diana E.; Mojón, Artemio; Fernández, José R.

doi:10.1007/s00125-015-3833-z

Cited by 3 publications

(1 citation statement)

References 20 publications

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“…[47][48][49][50] The MAPEC clinical trial (2156 hypertensive participants with follow-up 5.6 years) similarly showed that evening (vs morning) administration of BP medications resulted in improved clinical outcomes with reduction in total cardiovascular events and death by 67%, and prevention of CKD. 9,22,[51][52][53][54] In contrast, there have been a few smaller-powered studies with various study designs that reported no difference between evening and morning administration of anti-hypertensive medications. 14,55 One such study, the HARMONY trial, transplantation.…”

Section: Discussionmentioning

confidence: 99%

Restoration of nocturnal blood pressure dip and reduction of nocturnal blood pressure with evening anti‐hypertensive medication administration in pediatric kidney transplant recipients: A pilot randomized clinical trial

Sethna

Grossman

Dhanantwari

et al. 2020

Pediatric Transplantation

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Non-dipping and nocturnal hypertension are commonly found during ABPM in pediatric kidney transplant recipients. These entities are independently associated with increased cardiovascular disease risk in adults. Kidney transplant recipients aged 5-21 years with eGFR > 30 mL/min/1.73 m 2 and ABPM demonstrating nondipping status and normal daytime BP were randomized to intervention (short acting BP medication added in the evening) or control (no medication change) in this pilot, randomized, open-label, blinded end-point clinical trial. ABPM, echocardiography, and PWV were performed at baseline, 3 months, and 6 months. The trial included 17 intervention and 16 control participants. Conversion to dipper status occurred in 53.3% vs 7.7% (P = .01) at 6 months for intervention and controls, respectively. Systolic dip was greater in the intervention group compared to controls (10.9 ± 4.5 vs 4.2 ± 4.6, P = .001), and average systolic nighttime BP was significantly lower in the intervention group (106 ± 8.3 vs 114.9 ± 9.5 mm Hg, P = .01) at 6 months. There were no significant differences in LVMI, PWV, or eGFR between groups. Within-group changes in the intervention group demonstrated improvements in non-dippers, dipping, systolic nighttime BP and nighttime BP load. Restoration of nocturnal dip and improvement in nocturnal BP were observed in the population following chronotherapy. Future studies are needed with larger sample sizes over a longer period of time to delineate the long-term effect of improved nocturnal dip on target organ damage. K E Y W O R D S ambulatory blood pressure monitoring, chronotherapy, nocturnal hypertension, non-dipping, pediatric renal transplant, randomized clinical trial How to cite this article: Sethna CB, Grossman LG, Dhanantwari P, et al. Restoration of nocturnal blood pressure dip and reduction of nocturnal blood pressure with evening anti-hypertensive medication administration in pediatric kidney transplant recipients: A pilot randomized clinical trial.

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Section: Discussionmentioning

confidence: 99%

Restoration of nocturnal blood pressure dip and reduction of nocturnal blood pressure with evening anti‐hypertensive medication administration in pediatric kidney transplant recipients: A pilot randomized clinical trial

Sethna

Grossman

Dhanantwari

et al. 2020

Pediatric Transplantation

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Blood Pressure Variability and Autonomic Dysfunction

Spallone

2018

Curr Diab Rep

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Nocturnal hypertension in primary care patients with high office blood pressure: A regional study of the MAPAGE project

Zabawa¹,

Charra²,

Waldner³

et al. 2020

J of Clinical Hypertension

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Nocturnal hypertension (NH) is an independent cardiovascular risk factor. We aimed to describe the frequency of NH among primary care hypertensive patients and to analyze NH determinants. This observational, cross‐sectional, multicenter study enrolled the patients of 23 general practitioners in Burgundy region, France. We included the first patient of the day with office blood pressure ≥ 140/90 mm Hg, whatever the reason for consultation. All included patients had 24‐hour ambulatory blood pressure monitoring (ABPM). Nocturnal hypertension was considered nighttime mean blood pressure ≥ 120/70 mm Hg, as per current guidelines. Medical, sociodemographic, and deprivation data were collected. Nocturnal hypertensive and non‐hypertensive patients were compared. The determinants of NH were identified using logistic regression models. From July 2015 to November 2018, 447 patients were analyzed. Mean office blood pressure was 158.6/91.5 mm Hg, and 255 patients (57.0%) were taking at least one antihypertensive drug. Among the 409 (91.5%) valid ABPM, 316 (77.3%) showed NH. In multivariate analyses, male sex (odds ratio [OR] = 2.20, 95% confidence interval [CI] 1.29‐3.75), first office diastolic blood pressure >100 mm Hg (OR = 5.71, 95% CI 1.53‐21.40), and current smoking (OR = 5.91, 95% CI 2.11‐16.56) were independent predictors of NH. Obesity was associated with a reduced risk of NH (OR = 0.43, 95% CI 0.25‐0.75). No association was found between deprivation status or sociodemographic factors and NH. To conclude, NH was identified in more than three out of four patients with high office blood pressure. Male smokers with high diastolic blood pressure were most affected by NH. ABPM may improve hypertension management in these patients.

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Elevated asleep BP as predictor of type 2 diabetes and therapeutic target for prevention

Cited by 3 publications

References 20 publications

Restoration of nocturnal blood pressure dip and reduction of nocturnal blood pressure with evening anti‐hypertensive medication administration in pediatric kidney transplant recipients: A pilot randomized clinical trial

Restoration of nocturnal blood pressure dip and reduction of nocturnal blood pressure with evening anti‐hypertensive medication administration in pediatric kidney transplant recipients: A pilot randomized clinical trial

Blood Pressure Variability and Autonomic Dysfunction

Nocturnal hypertension in primary care patients with high office blood pressure: A regional study of the MAPAGE project

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