Morning pressor surge, blood pressure variability, and arterial stiffness in essential hypertension.
J Hypertens
; 35(2): 272-278, 2017 02.
Article
em En
| MEDLINE
| ID: mdl-28005700
ABSTRACT
OBJECTIVE:
An excess morning blood pressure surge (MBPS) may portend an increased cardiovascular risk, but the mechanisms thereof have been little investigated. The link between MBPS, short-term blood pressure (BP) variability, and arterial stiffness has not been entirely defined.METHODS:
In 602 consecutive untreated hypertensive patients (48â±â12 years, 61% men, office BP 149/93â±â17/10âmmHg), we measured carotid-femoral pulse wave velocity (cf-PWV, SphygmoCor) and 24-h ambulatory BP. Using self-reported sleep and wake times, MBPS was defined as sleep-trough (ST-MBPS), prewaking, rising. Short-term BP variability was calculated as weighted 24-h SBP SD and average real variability of 24-h SBP (ARV), that is, average of absolute differences between consecutive SBP readings.RESULTS:
ST-MBPS (râ=â0.16, Pâ<â0.001) and rising MBPS (râ=â0.12, Pâ=â0.003) showed a direct correlation with cf-PWV, whereas prewaking MBPS had no such relation (râ=â0.06, Pâ=â0.14). Only ST-MBPS was independently associated with cf-PWV (tâ=â1.96, Pâ=â0.04) after adjustment for age, sex, height, office mean arterial pressure, heart rate, and renal function. This association was lost after further adjustment for weighted 24-h SBP SD (Pâ=â0.13) or ARV (Pâ=â0.24). ARV was a significant mediator of the relationship between ST-MBPS and cf-PWV (Pâ=â0.003).CONCLUSION:
In untreated hypertension, ST-MBPS has a direct relation with aortic stiffness, which is mediated by an increased ARV. The adverse effects of MBPS may be partly explained by its link with arterial stiffness, mediated by short-term SBP variability.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Sono
/
Pressão Sanguínea
/
Rigidez Vascular
/
Hipertensão
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article