Pressão arterial de 24 horas em mulheres idosas normotensas e com hipertensão do avental branco / 24-hour blood pressure in normotensive elderly women and elderly women with white-coat hypertension

FUNDAMENTO: Mudanças no comportamento do ritmo circadiano podem ser deletérias, levando à lesão de órgãos-alvo, o que sugere ser de importante significado prognóstico e, eventualmente, podem também demandar intervenção terapêutica. OBJETIVO: Descrever e comparar os ritmos circadianos de pressão arterial (PA) entre mulheres idosas normotensas e portadoras de hipertensão do avental branco (HAB). MÉTODOS: Estudo transversal em uma amostra de 36 pacientes, com idades entre 60-83 anos, submetidas à monitorização ambulatorial de pressão arterial (MAPA) durante 24 horas. Dezenove idosas normotensas e 17 com HAB foram comparadas quanto à queda noturna e variabilidade de PA, ascensão matinal da PAS, pressão de pulso, hipotensão pós-prandial e correlação de médias de PA de 24 horas. Na análise estatística, utilizou-se o teste t de Student, teste do qui-quadrado, teste exato de Fisher e teste de correlação linear de Pearson. RESULTADOS: As idosas com HAB apresentaram níveis mais elevados de PAS do que as normotensas, entre 8-12 horas (133 ± 8,0 mmHg vs 123 ± 9,0 mmHg, respectivamente, p < 0,001). A variabilidade da PA foi mais elevada no grupo de HAB apenas no período de vigília (entre 7-23 horas, p = 0,02). Constatou-se correlação positiva entre o IMC e as médias de PAS, à noite, apenas nas idosas com HAB (r = 0,578; p = 0,015 e r = 0,488; p = 0,055, respectivamente). CONCLUSÃO: As idosas portadoras de HAB apresentaram médias de PAS e PAD mais elevadas na vigília. Nas primeiras horas da manhã, as idosas com HAB apresentaram médias significativamente mais altas de PAS.

BACKGROUND: Changes in the behavior of the circadian rhythm can be deleterious, leading to target-organ damage, which suggests that they can have a prognostic significance and, eventually, can also demand therapeutic intervention. OBJECTIVE: To describe and compare the circadian rhythms of blood pressure (BP) in normotensive elderly women and in those with white-coat hypertension (WCH). METHODS: A cross-sectional study was carried out in sample of 36 patients, aged 60-83 years, submitted to ambulatory blood pressure monitoring (ABPM) for a period of 24 hours. Nineteen normotensive elderly women and 17 with WHC were compared regarding the nocturnal dipping and the BP variability, morning increase in systolic blood pressure (SBP), pulse pressure, post-prandial hypotension and correlation of 24-hour BP means. The statistical analysis used the Student's t test, Chi-square test, Fisher's exact test and Pearson's linear correlation. RESULTS: The elderly women with WCH presented higher levels of SBP than the normotensive ones, between 8 am-12 pm (133 ± 8.0 mmHg vs 123 ± 9.0 mmHg, respectively, p < 0.001). The BP variability was higher in the WCH group only during the wakefulness period (between 7 am-11 pm, p = 0.02). A positive correlation was observed between the BMI and the SBP means at night, only in the elderly women with WCH (r = 0.578; p = 0.015 and r = 0.488; p = 0.055, respectively). CONCLUSION: The elderly women with WCH presented higher SBP and diastolic blood pressure (DBP) means during the wakefulness period. In the early hours of the morning, the elderly women with WCH presented significantly higher SBP means.

[24-hour blood pressure in normotensive elderly women and elderly women with white-coat hypertension]. / Pressão arterial de 24 horas em mulheres idosas normotensas e com hipertensão do avental branco.

BACKGROUND: Changes in the behavior of the circadian rhythm can be deleterious, leading to target-organ damage, which suggests that they can have a prognostic significance and, eventually, can also demand therapeutic intervention. OBJECTIVE: To describe and compare the circadian rhythms of blood pressure (BP) in normotensive elderly women and in those with white-coat hypertension (WCH). METHODS: A cross-sectional study was carried out in sample of 36 patients, aged 60-83 years, submitted to ambulatory blood pressure monitoring (ABPM) for a period of 24 hours. Nineteen normotensive elderly women and 17 with WHC were compared regarding the nocturnal dipping and the BP variability, morning increase in systolic blood pressure (SBP), pulse pressure, post-prandial hypotension and correlation of 24-hour BP means. The statistical analysis used the Student's t test, Chi-square test, Fisher's exact test and Pearson's linear correlation. RESULTS: The elderly women with WCH presented higher levels of SBP than the normotensive ones, between 8 am-12 pm (133 +/- 8.0 mmHg vs 123 +/- 9.0 mmHg, respectively, p < 0.001). The BP variability was higher in the WCH group only during the wakefulness period (between 7 am-11 pm, p = 0.02). A positive correlation was observed between the BMI and the SBP means at night, only in the elderly women with WCH (r = 0.578; p = 0.015 and r = 0.488; p = 0.055, respectively). CONCLUSION: The elderly women with WCH presented higher SBP and diastolic blood pressure (DBP) means during the wakefulness period. In the early hours of the morning, the elderly women with WCH presented significantly higher SBP means.