Nocturnal blood pressure in normotensive subjects and those with white coat, primary, and secondary hypertension

Middeke, Martin; Schrader, J

doi:10.1136/bmj.308.6929.630

Cited by 124 publications

(56 citation statements)

References 7 publications

(1 reference statement)

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“…A German study measured 24-hour ambulatory BP in 176 normotensive, 460 mild-to-moderate hypertensive, and 14 hyperthyroid patients. 21 The day/night change in BP was similar between normotensive (-14/-13 mm Hg) and hypertensive (-15/-14 mm Hg) study participants, but was significantly less among hyperthyroid patients (-6/-8 mm Hg; p<0.05). Another study compared 20 normotensive hyperthyroid and 15 healthy euthyroid patients using ambulatory BP monitoring.…”

Section: Effect Of Thyroid Hormone On the Cardiovascular Systemmentioning

confidence: 83%

Hyperthyroidism: A Secondary Cause of Isolated Systolic Hypertension

Prisant

Gujral

Mulloy

2006

J of Clinical Hypertension

139

103

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Section: Effect Of Thyroid Hormone On the Cardiovascular Systemmentioning

confidence: 83%

Hyperthyroidism: A Secondary Cause of Isolated Systolic Hypertension

Prisant

Gujral

Mulloy

2006

J of Clinical Hypertension

139

103

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“…This finding is in concordance with the results of Middeke, but the number of subjects in each group with endocrine hypertension used in this study was very small. 1 The second study focused on assessing of circadian BP variation in endocrine disorders found diminished diurnal BP variation only in pheochromocytoma subjects but not in primary aldosteronism. 2 The difference in the circadian BP variation between pheochromocytoma and steroid-induced adrenal hypertension shows that different pathophysiological condition leads to the different attenuation of the circadian BP rhythmicity.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] However, these observations are of limited value because either a small number of studied subjects have been used in previous reports (especially in the case of pheochromocytoma) or controversial results have been published regarding the circadian BP pattern in primary aldosteronism and also in pheochromocytoma. 1,2,[7][8][9][10][11][12][13][14] Until now, no study has been focused on differences in diurnal BP variations between the steroid-and catecholamine-induced hypertension.…”

Section: Introductionmentioning

confidence: 99%

Diurnal blood pressure variationin pheochromocytoma, primary aldosteronism and Cushing's syndrome

et al. 2004

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We examined circadian blood pressure (BP) variation (expressed as a relative night-time BP decline) in subjects with primary aldosteronism (78 patients), pheochromocytoma (n ¼ 45) and Cushing's syndrome (n ¼ 18). Subjects with aldosterone-producing adenoma (n ¼ 21) and pheochromocytoma (n ¼ 27) were also investigated after the tumour removal. In all, 65 patients with essential hypertension served as a control group. The night-time BP decline was significantly attenuated in all three forms of endocrine hypertension compared to the control group (primary aldosteronism Po0.0001, pheochromocytoma Po0.0001 for systolic and diastolic BP and Cushing's syndrome Po0.0001/o0.001 vs essential hypertension). In the case of pheochromocytoma, the absence of the night-time BP decrease was more prominent compared to the primary aldosteronism group (P ¼ 0.003/0.001) and for the diastolic BP also in comparison with the Cushing's syndrome group (P ¼ 0.03). Tumour removal led in both groups to the restoration of the previously altered circadian rhythm (aldosterone-producing adenoma: P ¼ 0.0005/0.0009; pheochromocytoma: P ¼ 0.001/0.0007). Our study demonstrates a blunted circadian BP variation in all forms of adrenal hypertension in comparison with essential hypertension. This reduction of the night-time BP decrease was more prominent in pheochromocytoma than in primary aldosteronism or Cushing's syndrome.

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“…[10][11][12][13][14] In particular, some hypertensive patients do not exhibit the normal nocturnal BP fall, and they have been called 'non-dippers', whereas those with normal circadian rhythm have been called 'dippers'. [15][16][17][18] Moreover, studies that used AMBP showed that the reduction in night time BP seems to lower in secondary forms of hypertension. [17][18][19][20][21] The aim of our study was to assess the behaviour of BP by ABPM in patients with PHPT, evaluating the prevalence of hypertension and the 'dipper' phenomenon.…”

Section: Introductionmentioning

confidence: 99%

Ambulatory monitoring of blood pressure (AMBP) in patients with primary hyperparathyroidism

et al. 2005

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The purpose of our study was to evaluate the behaviour of blood pressure (BP) by ambulatory monitoring of blood pressure (AMBP) in 53 patients with primary hyperparathyroidism (PHPT) compared to 100 essential hypertensive (EH) and 31 healthy subjects (HS). The correlations between calcium-phosphorus metabolism and haemodynamic parameters in all groups are included in the study. AMBP was performed using the oscillometric technique (Space-Labs, 90207, Redmond, WA, USA) and the following AMBP parameters were evaluated: average day time systolic (S) and diastolic (D) blood pressure (BP) and heart rate (HR) (when awake), average night time SBP, DBP and HR (when asleep) and average 24-h-SBP, DBP and HR. The definition of 'dipper' or 'non-dipper' subjects was established if night time SBP and DBP fall was 410% and o10%, respectively. In total, 25 PHPT patients (47.2%) were hypertensive (HT-PHPT) and 28 PHPT (52.8%) were normotensive (NT-PHPT). Mean 24-h-SBP and DBP obtained by AMBP was higher in HT-PHPT (Po0.05) and EH (Po0.05) than in NT-PHPT and HS. The multiple linear regression has shown that in PHPT-HT patients ionized calcium is an independent factor for the rise of 24-h-DBP values (r: 0.497; Po0.05) and daytime DBP values (r: 0.497; Po0.05). In 56% of HT-PHPT patients there is an absence of physiological BP nocturnal fall ('non-dipper'), which is statistically significant (Po0.05) compared with 'nondipper' EH patients (30%). In conclusion, in our study the prevalence of hypertension in PHPT was 47%. AMBP revealed that the 'non-dipping 'pattern was much higher in HT-PHPT patients in respect to EH patients.

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Nocturnal blood pressure in normotensive subjects and those with white coat, primary, and secondary hypertension

Cited by 124 publications

References 7 publications

Hyperthyroidism: A Secondary Cause of Isolated Systolic Hypertension

Hyperthyroidism: A Secondary Cause of Isolated Systolic Hypertension

Diurnal blood pressure variationin pheochromocytoma, primary aldosteronism and Cushing's syndrome

Ambulatory monitoring of blood pressure (AMBP) in patients with primary hyperparathyroidism

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