Seasonal variation in ambulatory blood pressure control in patients on clinic blood pressure-guided antihypertensive treatment.
J Hypertens
; 42(5): 909-916, 2024 May 01.
Article
in En
| MEDLINE
| ID: mdl-38230620
ABSTRACT
BACKGROUND:
We investigated seasonal variation in ambulatory blood pressure control in hypertensive patients on clinic blood pressure-guided antihypertensive treatment.METHODS:
The study participants were hypertensive patients enrolled in an 8-week therapeutic study. Antihypertensive treatment was initiated with long-acting dihydropyridine calcium channel blockers amlodipine 5âmg/day or the gastrointestinal therapeutic system (GITS) formulation of nifedipine 30âmg/day, with the possible up-titration to amlodipine 10âmg/day or nifedipine-GITS 60âmg/day at 4âweeks of follow-up.RESULTS:
The proportion of up-titration to higher dosages of antihypertensive drugs at 4âweeks of follow-up was higher in patients who commenced treatment in autumn/winter ( n â=â302) than those who commenced treatment in spring/summer ( n â=â199, 24.5 vs. 12.0%, P â<â0.001). The control rate of clinic blood pressure, however, was lower in autumn/winter than in spring/summer at 4 (56.7 vs. 70.7%, P â=â0.003) and 8âweeks of follow-up (52.5 vs. 74.9%, P â<â0.001). At 8âweeks, patients who commenced treatment in autumn/winter, compared with those who commenced treatment in spring/summer, had a significantly ( P ≤0.03) smaller daytime (mean between-season difference -3.2/-2.8âmmHg) but greater nighttime SBP/DBP reduction (3.6/1.6âmmHg). Accordingly, at 8âweeks, the prevalence of nondippers was significantly ( P â<â0.001) higher in spring/summer than in autumn/winter for both SBP (54.8 vs. 30.0%) and DBP (53.4 vs. 28.8%).CONCLUSION:
Clinic blood pressure-guided antihypertensive treatment requires a higher dosage of medication in cold than warm seasons, which may have led to over- and under-treatment of nighttime blood pressure, respectively.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Hypertension
/
Antihypertensive Agents
Type of study:
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
J Hypertens
Year:
2024
Document type:
Article
Affiliation country:
China