Prognostic significance of blood pressure measured on rising

Gosse, Philippe; Cipriano, C.; Bémurat, L; D, Mas; Lemétayer, P; N'tela, Gilbert; Clémenty, Jacques

doi:10.1038/sj.jhh.1001187

Cited by 29 publications

(18 citation statements)

References 18 publications

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“…Clinically relevant information can be utilized by simply having patients measure their blood pressure in the early morning, soon after arising (20), such readings are elevated in most patients. If they are elevated, the need for more effective, long-acting antihypertensive therapy is established.…”

Section: Resultsmentioning

confidence: 99%

Non-dipping morning blood pressure and isolated systolic hypertension in elderly

Snincak²,

Pahuli³

et al. 2013

BLL

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Abstract:Objective: Morning hypertension is currently the blind spot in the clinical practice of hypertension, home 24-hour blood pressure measurement has been recommended in patients with a high clinic blood pressure and patients with target organ damage. Aim: To assess whether an increased early morning blood pressure surge, established via a single 24-hour blood pressure monitoring, in treated elderly hypertensive's is related to more prominent target organ damage. Material and methods: 310 treated hypertensive patients randomly attended the out-patient clinic of our hypertension centre. The patients were divided in 2 groups: systolic/diastolic blood pressure hypertension (n = 266) and isolated systolic hypertension (n = 44 76 ±10 yrs). Results: Equivalent in both males and females, despite the rise in nondippers with an early morning surge (higher in females). Hyperlipidemia arises equally in dippers and nondippers, 45 % of nondippers had diabetes mellitus; 30 % suffered previous renal insuffi ciency and about 29 % of patients suffered from an endocrine disorder, mostly thyroid. Metabolic syndrome was only found to be associated with a nondipping pattern (3 %). Left ventricular hypertrophy was present in 100 % of patients, heart failure in 60 % nondippers and 56 % dippers, potential renal insuffi ciency in 34 % nondippers and 22 % dippers, retinopathy in 31 % non dippers and 11 % dippers, aortic aneurysm was only in nondippers. Conclusion: Early morning surge is a predictor of hypertensive target organ damage, being a dipper or nondipper patient with isolated systolic hypertension, might not make a difference depending on one's own degree of target organ damage and diurnal variation (Fig. 2 Despite a diffi culty to diagnose and treat hypertension, this condition remains worldwide the leading cause of cardiovascular morbidity and mortality and goal blood pressure levels are seldom achieved. It is therefore highly desirable to improve this unsatisfactory delivery of care in the fi eld of hypertension, an increasing number of clinical trials allow the formulation of guidelines to support a more effective strategy. Multifaceted interventions are required to implement guidelines successfully, going from the dissemination of recommendations to educational programs at the practice site. This paper is a current contribution to the above directionThe following are the main aims: 1) To prove the link between isolated systolic increase in blood pressure (non-dippers) and the incidence of hypertension in elderly subjects.2) To compare the use of non-invasive blood pressure investigational methods versus management.3) Prognosis of cardiovascular and cerebrovascular disease resulting from ISH in non-dippers? Material and methodsThe extent to which the morning BP surge is a direct cause of cardiovascular disease is still to be proven, but a clear association has been demonstrated. An excessive morning blood pressure surge appears to be a risk factor for cardiovascular disease, particularly in older hypertensive patients wi...

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Section: Resultsmentioning

confidence: 99%

Non-dipping morning blood pressure and isolated systolic hypertension in elderly

Snincak²,

Pahuli³

et al. 2013

BLL

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“…The morning rise in blood pressure represented 36.2% of the total variance of LVMI, and all the remaining factors, including morning HSBP, HOMA-IR and age, represented only 7.9% of the variance. Morning rise in blood pressure (4-6) and high morning blood pressure itself (7-9) have been noted as predictors of hypertensive target organ damage, but these previous studies were mainly population-based studies (5,8) or cross-sectional studies in untreated hypertensive patients (4,7,9). A population-based study in Ohasama showed that subjects with morning HSBP over 138 mmHg had a high relative risk for cardiovascular events compared to normotensive subjects (8).…”

Section: Discussionmentioning

confidence: 99%

Morning Rise in Blood Pressure Is a Predictor of Left Ventricular Hypertrophy in Treated Hypertensive Patients

et al. 2004

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“…It is known that mild elevation of BP and HR result from activation of the autonomic nerve system. In humans, cardiovascular events occur most frequently in the morning, and a steep morning elevation of SBP and HR, along with the resultant higher elevation of DP, are associated with event risk [3,6,9,11]. In dogs, patients with valvular disorder and higher myocardial oxygen consumption due to augmentation of diastolic overload may experience increased cardiac load due to steep elevation of DP at feeding time.…”

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confidence: 99%

Effect of Diet on the Cardiovascular System in Healthy Beagles

Nakagawa

Miyagawa

Takemura

et al. 2010

The Journal of Veterinary Medical Science

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ABSTRACT. In management of canine cardiac disorders, cardiac drugs are commonly administered with food, although the cardiovascular effects of feeding and frequency of feeding are unknown. This study investigated the cardiovascular effect of feeding and frequency of feeding using a telemetry monitoring system in unanesthetized and unrestrained dogs. Systolic and diastolic blood pressure, heart rate and double product were steeply elevated during the five minutes immediately before feeding. They showed a sharp fall within 60 min after feeding time, especially the systolic and diastolic blood pressure, which showed lower values than from before feeding time. There were no significant differences in the means of preprandial elevation, postprandial fall or 24-hr averages in the once-and twice-daily feeding periods.KEY WORDS: blood pressure, canine, cardiovascular effect, feeding, telemetry system. J. Vet. Med. Sci. 72(5): 615-619, 2010 Cardiovascular disorders are common in elderly dogs, one-third of which have been shown to suffer from valvular heart disease [2]. Vasodilators such as angiotensin-converting enzyme inhibitors, beta-blockers and diuretics are commonly prescribed in this situation [2], and these drugs are usually administered with food for the sake of convenience. Some studies [5,12,13] that have used telemetry systems to track systolic blood pressure (SBP) and diastolic blood pressure (DBP) in dogs have suggested that feeding regimens affect canine variations of blood pressure (BP) and heart rate (HR). Household dogs are generally fed once or twice a day, depending on the lifestyle of the owner, and the precise cardiovascular effects of various times of feeding are not known. The purpose of this study was to examine the influence of feeding and times of feeding on the variation of BP, HR and double product (DP), a parameter of oxygen consumption, in healthy Beagles.Animals: Three healthy female Beagles (mean age of 7.3  4.6 years; mean weight of 9.1  0.3 kg) were used in this study. Based on the results of a physical examination, complete blood count and serum chemistry, the dogs were confirmed to be healthy. They were acclimated for 10 weeks under experimental conditions at the Laboratory of Veterinary Internal Medicine, School of Veterinary Medicine, Nippon Veterinary and Life Science University.Feeding time: Food (Hill's Science Diet Canine Maintenance) was given at 15:00 in the once-daily feeding group and at 9:00 and 17:00 in the twice-daily feeding group. Water was given ad libitum.Experimental environment: The dogs were housed in individual stainless steel cages measuring 710 (W)  1,095 (D)  795 (H) mm. The cages were placed under environment conditions similar to those for household animals; human entry to the room was unlimited from 7:00-24:00, and neither the room temperature nor the lighting cycle was controlled.Procedures: This experiment was carried out in a crossover design. Placement of a BP telemetry system (Data Science International, New Brighton, MN, U.S.A.) and collection o...

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Prognostic significance of blood pressure measured on rising

Cited by 29 publications

References 18 publications

Non-dipping morning blood pressure and isolated systolic hypertension in elderly

Non-dipping morning blood pressure and isolated systolic hypertension in elderly

Morning Rise in Blood Pressure Is a Predictor of Left Ventricular Hypertrophy in Treated Hypertensive Patients

Effect of Diet on the Cardiovascular System in Healthy Beagles

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