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Nocturnal hypertension in primary care patients with high office blood pressure: A regional study of the MAPAGE project.
Zabawa, Claire; Charra, Clément; Waldner, Anne; Morel, Gilles; Zeller, Marianne; Guilloteau, Adrien; Mazalovic, Katia.
Afiliação
  • Zabawa C; Department of general medicine, UFR Sciences de Santé, Bourgogne Franche-Comté University, Dijon, France.
  • Charra C; Department of general medicine, UFR Sciences de Santé, Bourgogne Franche-Comté University, Dijon, France.
  • Waldner A; Department of general medicine, UFR Sciences de Santé, Bourgogne Franche-Comté University, Dijon, France.
  • Morel G; Department of general medicine, UFR Sciences de Santé, Bourgogne Franche-Comté University, Dijon, France.
  • Zeller M; EA 7460 Cerebro-Cardiovascular Physiopathology and Epidemiology (PEC2), UFR Sciences de Santé, Bourgogne Franche-Comté University, Dijon, France.
  • Guilloteau A; INSERM, U1231, Epidemiology and Clinical Research in Digestive Oncology, Dijon, France; UMR1231, EPICAD team, Bourgogne Franche-Comté University, Dijon, France.
  • Mazalovic K; Department of general medicine, UFR Sciences de Santé, Bourgogne Franche-Comté University, Dijon, France.
J Clin Hypertens (Greenwich) ; 22(6): 991-1008, 2020 06.
Article em En | MEDLINE | ID: mdl-32511889
Nocturnal hypertension (NH) is an independent cardiovascular risk factor. We aimed to describe the frequency of NH among primary care hypertensive patients and to analyze NH determinants. This observational, cross-sectional, multicenter study enrolled the patients of 23 general practitioners in Burgundy region, France. We included the first patient of the day with office blood pressure ≥ 140/90 mm Hg, whatever the reason for consultation. All included patients had 24-hour ambulatory blood pressure monitoring (ABPM). Nocturnal hypertension was considered nighttime mean blood pressure ≥ 120/70 mm Hg, as per current guidelines. Medical, sociodemographic, and deprivation data were collected. Nocturnal hypertensive and non-hypertensive patients were compared. The determinants of NH were identified using logistic regression models. From July 2015 to November 2018, 447 patients were analyzed. Mean office blood pressure was 158.6/91.5 mm Hg, and 255 patients (57.0%) were taking at least one antihypertensive drug. Among the 409 (91.5%) valid ABPM, 316 (77.3%) showed NH. In multivariate analyses, male sex (odds ratio [OR] = 2.20, 95% confidence interval [CI] 1.29-3.75), first office diastolic blood pressure >100 mm Hg (OR = 5.71, 95% CI 1.53-21.40), and current smoking (OR = 5.91, 95% CI 2.11-16.56) were independent predictors of NH. Obesity was associated with a reduced risk of NH (OR = 0.43, 95% CI 0.25-0.75). No association was found between deprivation status or sociodemographic factors and NH. To conclude, NH was identified in more than three out of four patients with high office blood pressure. Male smokers with high diastolic blood pressure were most affected by NH. ABPM may improve hypertension management in these patients.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Monitorização Ambulatorial da Pressão Arterial / Hipertensão Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País como assunto: Europa Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Monitorização Ambulatorial da Pressão Arterial / Hipertensão Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País como assunto: Europa Idioma: En Ano de publicação: 2020 Tipo de documento: Article