Résumé
Objective: To explore the association of blood pressure variability (BPV), especially diurnal blood pressure rhythm with brachial ankle pulse wave velocity (baPWV) and left ventricular mass index (LVMI). Methods: A total of 184 hypertensive patients participated this cross sectional study. Patients were divided into dippers, non-dippers, inverted dippers and extreme dippers groups according to nocturnal systolic blood pressure (SBP) decline. baPWV and LVMI in different groups were compared. Correlation of baPWV and LVMI with blood pressure and BPV variables were analyzed by univariate and multivariate regression analysis. Results: After adjusted by age, BMI, hypertension duration, blood pressure in consulting room, SBP and diastolic blood pressure (DBP) in 24 h, total cholesterol, low density lipoprotein cholesterin, brain natriuretic peptide and ejection fraction, baPWV in non-dippers group and inverted-dippers group were significantly higher than that in dippers group and extreme dippers group (P=0.000), and LVMI was significantly higher in non-dippers group than in dippers group (P=0.001) and extreme-dippers group (P=0.022). baPWV and LVMI were both significantly correlated to age, 24 h SBP and 24 h DBP, SD value of 24 h SBP and 24 h DBP, daytime SBP and DBP, nocturnal SBP and DBP, SD values of daytime SBP and DBP, SD values of nocturnal SBP and DBP in univariate linear regression models (P<0.05). In multivariate linear regression model, baPWV was independently associated to SD value of nocturnal SBP (β=0.289, P=0.000), nocturnal SBP decline (β=-0.398, P=0.000), daytime SBP (β=0.214, P=0.001) and SD value of daytime DBP (β=0.207, P=0.002), while LVMI was independently associated to 24 h SBP (β=0.348, P=0.000) and SD value of nocturnal SBP (β=0.196, P=0.026). Conclusion: baPWV was independently correlated to SD value of nocturnal SBP, nocturnal SBP decline, daytime SBP and SD value of daytime DBP, while LVMI was independently correlated to 24 h SBP and SD value of nocturnal SBP.
Résumé
Objective·To explore the association of blood pressure variability (BPV),especially diurnal blood pressure rhythm with brachial ankle pulse wave velocity (baPWV) and left ventricular mass index (LVMI).Methods· A total of 184 hypertensive patients participated this cross sectional study.Patients were divided into dippers,non-dippers,inverted dippers and extreme dippers groups according to nocturnal systolic blood pressure (SBP) decline.baPWV and LVMI in different groups were compared.Correlation of baPWV and LVMI with blood pressure and BPV variables were analyzed by univariate and multivariate regression analysis.Results· After adjusted by age,BMI,hypertension duration,blood pressure in consulting room,SBP and diastolic blood pressure (DBP) in 24 h,total cholesterol,low density lipoprotein cholesterin,brain natriuretic peptide and ejection fraction,baPWV in non-dippers group and inverted-dippers group were significantly higher than that in dippers group and extreme dippers group (P=0.000),and LVMI was significantly higher in non-dippers group than in dippers group (P=0.001) and extreme-dippers group (P=0.022).baPWV and LVMI were both significantly correlated to age,24 h SBP and 24 h DBP,SD value of 24 h SBP and 24 h DBP,daytime SBP and DBP,nocturnal SBP and DBP,SD values of daytime SBP and DBP,SD values of nocturnal SBP and DBP in univariate linear regression models (P＜0.05).In multivariate linear regression model,baPWV was independently associated to SD value of nocturnal SBP (β=0.289,P=0.000),nocturnal SBP decline (β=0.398,P=0.000),daytime SBP (β=0.214,P=0.001) and SD value of daytime DBP (β=0.207,P=0.002),while LVMI was independently associated to 24 h SBP (β=0.348,P=0.000) and SD value of nocturnal SBP (β=0.196,P=0.026).Conclusion· baPWV was independently correlated to SD value of nocturnal SBP,nocturnal SBP decline,daytime SBP and SD value of daytime DBP,while LVMI was independently correlated to 24 h SBP and SD value of nocturnal SBP.
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Objective To study the differences in 24 h ambulatory blood pressure of healthy young men between the plateau and the plains.Methods A total of 100 young men were enrolled in this study.They underwent 24 h ambulatory blood pressure monitoring on the plateau and on the plains respectively.The data was analyzed by SPSS.17.Results The 24 h mean systolic blood pressure (24HMSBP) and diastolic blood pressure (24HMDBP),day (6:00-22:00) mean systolic blood pressure (DMSBP) and diastolic blood pressure (DMDBP),night (22:00-6:00) mean systolic blood pressure (NMSBP) and diastolic blood pressure (NMDBP),24 h mean heart rate (24MHR),HRmax,HRmin,24 h systolic blood pressure load (24HSBPL) and diastolic blood pressure load (24HDBPL),day (6:00-22:00) systolic blood pressure load (DSBPL) and diastolic blood pressure load (DDBPL),night (22:00-6:00) systolic blood pressure load (NSBPL) and diastolic blood pressure load (NDBPL) were significantly different between the plateau and plains (all P ＜ 0.05).However,the systolic blood pressure decrease rate (SBPDR) and the diastolic blood pressure decrease rate (DBPDR),day systolic blood pressure coefficient of variation (DSBPCV) and diastolic blood pressure coefficient of variation (DBPCV),night systolic blood pressure coefficient of variation (NSBPCV) and diastolic blood pressure coefficient of variation (NBPCV) were not significantly different (P ＞ 0.05).Conclusion The systolic blood pressure (SBP)and diastolic blood pressure (DBP) on the plateau are significantly higher than those on the plains.24HMDBP and DMDBP increase more significantly on the plateau than those of SBP.The blood pressure load (BPL) on the plateau is higher than that on the plains,with a higher degree of dispersion,so are the 24 h mean heart rate (24MHR),HRmax,and HRmin.
Résumé
PURPOSE--To evaluate clinical efficacy and tolerability of isradipine SRO (I.SRO), 5 mg O.D. in essential hypertensives. METHODS--Eighty-three of 87 selected outpatients with a mean age of 51.3 years (ranging from 25 to 65), 33 male, 48 white, 29 black and others of different races, who had clinical supine and orthostatic diastolic blood pressure (DBP) > or = 95 mmHg and < or = 115 mmHg underwent the study. After a three-week wash-out period, patients received I.SRO 5 mg O.D. at 8:00 am for a six-week period (phase I). After this phase, patients received I.SRO 5 mg O.D. at 8:00 pm for a six-week period (phase II). The patients had a follow-up with an interval of three weeks and the ambulatorial blood pressure monitoring (ABPM) for 24 hours was performed with a SpaceLabs 90207 or Del Mar Avionics devices after the wash-out period and at the end of phases I and II. Measurements were performed at 15-min intervals during the day (6 am to 10 pm) and at 30-min intervals during the night (10 pm to 6 am). RESULTS--a) Heart rate did not show significant changes during the treatment period (phases I and II) when compared with the wash-out period; b) causal blood pressure: at the end of both treatment periods (phases I and II) there were statistically significant decreases (p < 0.001) in supine SBP and DBP compared with wash-out values. The mean SBP decreased from 161.6 +/- 14 to 144.3 +/- 13 mmHg (phase I) and to 141.8 +/- 13 mmHg (phase II). The mean DBP decreased from 103.4 +/- 6 to 91.2 +/- 7 (phase I) and to 89.1 +/- 8 (phase II); c) ABPM: the mean systolic 24-h ambulatory blood pressure was significantly reduced (p < 0.001) from 148.8 +/- 17 to 137.2 +/- 15 mmHg (phase I) and to 133.4 +/- 13 mmHg (phase II). The mean diastolic 24-h ambulatory blood pressure was significantly decreased (p < 0.001) from 94.3 +/- 9 to 87.0 +/- 9 (phase I) and to 85.8 +/- 8 mmHg (phase II). The mean daytime and nighttime, systolic and diastolic 24-h ambulatory blood pressure were: wash-out--152.3 +/- 17, 140.2 +/- 21, 97.4 +/- 9, 86.8 +/- 13; phase I--139.9 +/- 15, 130.0 +/- 17, 89.3 +/- 9, 81.3 +/- 10; phase II--136.7 +/- 13, 125.3 +/- 15, 88.5 +/- 8, 79.1 +/- 10, respectively. Blood pressure load (percentage of systolic blood pressure values > 140 mmHg or of diastolic blood pressure values > 90 mmHg) was significantly reduced from 62.2/62 per cent (SBP/DBP), on the was-out, to 37.9/39.9 per cent (SBP/DBP) on phase I and to 32.3/34.3 per cent (SBP/DBP) on phase II; d) side effects: most frequently related were palpitations (2.3 per cent ), headache (1.1 per cent ), flush (1 per cent ) and ankle oedema (1 per cent ). They were in general, mild-to-moderate and disappeared after the first 3 weeks of treatment. Only two patients were withdrawn because of headache (one of them with previous diagnosis of migraine). CONCLUSION--I.SRO, given by oral route, in the dosage of 5 mg O.D. as monotherapy, was effective and well tolerated, promoted significant reduction on 24-h ambulatory blood pressure attenuating the early morning rise and did not interfere with the circadian rhythm of blood pressure. No significant differences were detected in the BP lowering effect when I.SRO was given during the morning or evening. These results may indicate that the drug is as suitable as one of the first choice for treating mild and moderate hypertensive patients