The Circadian Rhythms of Blood Pressure and Heart Rate in the Hypertensive Subjects: Dippers and Non-Dippers

Seo, Wha Sook; Oh, Hyun Soo

doi:10.3349/ymj.2002.43.3.320

Cited by 28 publications

(21 citation statements)

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“…However, they differed by their nocturnal average SBP and DBP. Similar nocturnal variation had been reported in a study done by Seo W.S et al [8]. This observation strengthens the importance of the contribution of nocturnal hypertension in hypertensive patients.…”

Section: Nocturnal Dippingsupporting

confidence: 91%

“…This element has been highlighted in several other studies as well [8]. In this study, the patients were advised to abstain from vigorous physical activity since that can give rise to high blood pressure values which may markedly affect the diurnal variation.…”

Section: Variation Of Day Time and Nocturnal Blood Pressurementioning

confidence: 94%

“…Twenty-four-hour ABPM was performed, and the patients underwent electrocardiography and twodimensional echocardiographic assessment performed independently by two cardiology senior registrars. Manual BP measurement was performed according to a standard protocol [8]. Informed written consent was obtained from all participants.…”

Section: Methodsmentioning

confidence: 99%

“…There was no statistically significant difference (p=0.866) noted in the average nocturnal HR in non-dippers (64.9/min) compared to dippers (67.4/min). HR non dippers, defined as those who showed a nocturnal dip in HR of less than 10% of the day time value [8], accounted for 65% (n=65) of the subjects.…”

Section: Non Dippersmentioning

confidence: 99%

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Circadian blood pressure profile and comparison with clinic blood pressure in patients with essential hypertension on treatment; experience from a Teaching Hospital in Sri Lanka

Bandara

Hewarathne

Karunarathne

et al. 2017

J. Postgrad. Inst. Med.

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Background and ObjectivesAmbulatory blood pressure monitoring (ABPM) is more reflective of an individual's blood pressure (BP) profile and its control, eliminating several confounding and contributory factors. This study looked at the circadian pattern of BP variation with respect to nocturnal BP fluctuations and compared clinic BP measurements with ambulatory readings in patients on treatment for essential hypertension Methods A prospective study was conducted at Teaching Hospital, Kandy from August to October 2015. The study participants were 100 patients, above 18 years of age, with stage I to III essential hypertension with normal renal functions and having no history of coronary or cerebro-vascular events. All patients underwent electrocardiography, 2D echocardiography, manual BP measurement and 24-hour ambulatory blood pressure monitoring. ResultsThere was a female preponderance 72(72%) and the mean age was 61 ± 9 years. One third had uncontrolled BP, according to clinic BP readings, whereas 60% had uncontrolled BP according to ambulatory blood pressure monitoring. The agreement between the office BP and ABPM in diagnosing controlled or uncontrolled BP was low (58%, Kappa = 0.23). A significant statistical difference (p<0.001) was observed between day and night time measurements, irrespective of BP control. In the sample, 70% had abnormal dipping patterns including non-dipping (45%), reverse dipping (25%) and extreme dipping (5%). Conclusions and RecommendationsABPM is more reflective of an individual's naïve BP pattern. It captures the different types of diurnal variation of BP thus guiding the physician to treat the patient optimally. Moreover, its noninvasive and portable nature allows it to be used with ease. It is likely that ABPM will gather widespread recognition and acceptance as a more reliable diagnostic and prognostic tool in the future

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Section: Nocturnal Dippingsupporting

confidence: 91%

Section: Variation Of Day Time and Nocturnal Blood Pressurementioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Section: Non Dippersmentioning

confidence: 99%

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Circadian blood pressure profile and comparison with clinic blood pressure in patients with essential hypertension on treatment; experience from a Teaching Hospital in Sri Lanka

Bandara

Hewarathne

Karunarathne

et al. 2017

J. Postgrad. Inst. Med.

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show abstract

“…According to ambulatory blood pressure monitoring (ABPM) data, BP reaches the highest level in the morning, gradually declines during the day and stays at the lowest levels during the night [12]. In ABPM, a 10% or more decline in nocturnal blood pressure value compared to diurnal value was defined as "dipper" and a decline less than 10% was defined as "non-dipper" [13].…”

mentioning

confidence: 99%

Factors Related to Microalbuminuria in Patients with Chronic Obstructive Pulmonary Disease

Kaysoydu¹,

Arslan²,

Yıldız³

et al. 2014

Adv Clin Exp Med

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Background. Chronic obstructive pulmonary disease (COPD) is characterized by inhaled particles and gases inducing chronic inflammation of the airways accompanied by a not fully reversible airflow limitation. Systemic inflammation has an important role in the pathogenesis of COPD. In parallel, several comorbidites can be observed. Microalbuminuria is related to endothelial dysfunction. Microalbuminuria was increased in exacerbation periods of COPD. Objectives. The aim of the study was evaluate to the presence of microalbuminuria (MA) in patients with chronic obstructive pulmonary disease (COPD) and its relationship to inflammation, arterial blood gas parameters and 24-hour ambulatory blood pressure alterations. Material and Methods. Seventy COPD patients and 40 healthy volunteers were enrolled in the study. 24-h ambulatory blood pressure monitoring (ABPM) results, including pressure and pulse rates of the subjects were recorded and the cases were classified as "dipper" if a normal fall of more than 10% in blood pressure was observed at night and "non-dipper" if not. Routine renal function tests were performed, C-reactive protein (CRP) values were examined and urine samples were obtained to scrutinize the presence of MA. Patients were allocated into two groups, those with and without MA. The spirometry and arterial blood gas results of the patients were recorded. Results. The urinary albumin creatinin ratio (64.8 ± 91.8), CRP (21 ± 14.8), nocturnal systolic and diastolic blood pressure (118 ± 14 and 72 ± 10), nocturnal and diurnal pulse (87 ± 17 and 90 ± 14), nocturnal pulse pressure (49 ± 11), mean pulse (89 ± 15), mean pulse pressure (48 ± 10) and the number of non-dipper subjects (65) were found significantly higher in the COPD group than in the control group (10.6 ± 6, 5.4 ± 2.4, 105 ± 6 and 68 ± 7, 70 ± 10 and 78 ± 11, 42 ± 1, 75± 11, 42 ± 7 and 5, respectively); (p < 0.001, < 0.001, < 0.001 and 0.041, < 0.001 a nd < 0.001, < 0.001, < 0.001, < 0.001 and < 0.001, respectively). Nocturnal pulse (89 ± 17) and CRP (23.5 ± 14.8) were found to be significantly higher in COPD patients with MA than in COPD patients without MA (78 ± 8 and 8.8 ± 6.3, respectively); (p = 0.021 and < 0.001, respectively). Conclusions. The facts that CRP, a systemic inflammation marker, and mean nocturnal pulse pressure values were significantly higher in the group with MA among COPD patients, and that ambulatory blood pressure values did not differ between COPD patients with and without MA, suggest both a possible role of inflammation in MA development in COPD patients and a relationship between MA and increased heart rate (Adv Clin Exp Med 2014, 23, 5, 749-755).

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Evaluation of biochemical, hematological, and thyroid function parameters in nondipper and dipper hypertensive patients

Akpınar

Başar

Şen

et al. 2012

Wien Klin Wochenschr

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Thyroid function disorders are associated with hypertension. However, there are not enough data on the effects of thyroid hormones particularly on the nighttime blood pressure decrease in hypertensive patients. Although the exact mechanism between low thyroid hormone levels and nondipping hypertension development is not known, relatively low thyroid hormone levels in the nondipper group may be related to the decrease in vein wall compliance, considering the vascular effect of overt hypothyroidism.

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The Circadian Rhythms of Blood Pressure and Heart Rate in the Hypertensive Subjects: Dippers and Non-Dippers

Cited by 28 publications

References 0 publications

Circadian blood pressure profile and comparison with clinic blood pressure in patients with essential hypertension on treatment; experience from a Teaching Hospital in Sri Lanka

Circadian blood pressure profile and comparison with clinic blood pressure in patients with essential hypertension on treatment; experience from a Teaching Hospital in Sri Lanka

Factors Related to Microalbuminuria in Patients with Chronic Obstructive Pulmonary Disease

Evaluation of biochemical, hematological, and thyroid function parameters in nondipper and dipper hypertensive patients

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