Noninvasive Ambulatory Blood Pressure Monitoring During Clinic Visit in Elderly Hypertensive Patients

Shimada, Kazuyuki; Ogura, Hisakazu; Kawamoto, Akiko; Ishida, Hiroshi; Ozawa, Toshio

doi:10.3109/10641969009074725

Cited by 16 publications

(6 citation statements)

References 24 publications

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“…The ambulatory data used in the present study were obtained by an oscillometric method. The accuracy of this device was previously validated (19,20). There are no defined standards for the ambulatory blood pressure criteria of hypertension.…”

Section: Study Protocols 1) 24-hour Blood Pressure Monitoringmentioning

confidence: 99%

Power Spectral Analysis of Spontaneous Blood Pressure and Heart Rate Variability in Elderly Hypertensives.

et al. 1996

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To examine the influence of hypertension on cardiovascular variability in elderly subjects, we measured spontaneous beat-to-beat blood pressure (BPV) and heart rate variability (HRV) in elderly subjects with or without hypertension at rest and during tilting. The study group consisted of 23 community-dwelling, male elderly subjects (aged 62-75 years) and was divided into two groups, i.e., a hypertensive group (HT group; n=11) and normotensive group (NT group; n=12). According to the modeling and decomposing algorithm of an autoregressive process, we estimated the component power of low-frequency (LF; 0.03-0.15 Hz) and high-frequency components (HF; respiratory frequency) of BPV and HRV by power spectral analysis. We also measured plasma norepinephrine (PNE) levels in the two groups at rest and during tilting. In the HT group, we found that the amplitude of LF-BPV was greater (p < 0.05) and its relative change by postural tilting was smaller (p< 0.05) than those in the NT group. We found no significant difference in the amplitude of LF-HRV and HF-HRV between the two groups, and found no significant response of the amplitude of LF-HRV and HF-HRV to postural tilting. We also found no differ ence in PNE level between the two groups at rest or during tilting. These results suggest that the regulatory function of sympathetic vasomotor activity assessed by power spectral analysis of BPV is altered in hypertensive elderly subjects, although the influence of hypertension on the autonomic control of the heart is less dominant in the elderly. (Hypertens Res 1996; 19: 9-16) Key Words: spectral analysis, hypertension, elderly, sympathetic activity, orthostatic stress Power spectral analysis of heart rate and blood pressure variability has been used to assess the autonomic control of the cardiovascular system (1-5). In healthy humans, power spectral analysis of spontaneous beat-to-beat blood pressure variability (BPV) and heart rate variability (HRV) has demonstrated two major spectral components, i.e., a lowfrequency (LF) component at 0.03-0.15 Hz and a high-frequency (HF) component at respiratory frequency (1-5). Earlier studies (1, 3, 4, 6) suggest that 1) the LF component of BPV corresponds to Mayer waves in humans; 2) the HF component of BPV (Traube-Hering waves) depends mostly on the mechanical effects of respiration; 3) the LF component of HRV reflects Mayer waves through the baroreceptor reflex; and that 4) the HF component of HRV corresponds to the respiratory sinus arrhythmia and reflects parasympathetic activity. Recent human studies by power spectral analysis (1, 7) and early experimental studies (8-10) suggest that the Mayer waves reflect vasomotor tone mediated by sympathetic nervous activity.Increased sympathetic nervous activity plays an important role in the pathogenesis of essential hypertension.Increased plasma norepinephrine (PNE) levels (11, 12) and peroneal nerve activity (13) have been reported in hypertensive subjects. In power spectral analysis of HRV, sympathetic predominance was shown in hyperten...

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Section: Study Protocols 1) 24-hour Blood Pressure Monitoringmentioning

confidence: 99%

Power Spectral Analysis of Spontaneous Blood Pressure and Heart Rate Variability in Elderly Hypertensives.

et al. 1996

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“…The accuracy of this device was previously validated. 13 - 14 The ambulatory data used in the present study were those obtained by the oscillometric method. Subjects recorded a diary of action profile from which information about the precise times of falling asleep and waking up were obtained.…”

Section: Twenty-four-hour Blood Pressure Monitoringmentioning

confidence: 99%

Silent cerebrovascular disease in the elderly. Correlation with ambulatory pressure.

et al. 1990

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Does the average daily blood pressure correlate with hypertensive cerebrovascular disease better than the casual pressure, as has been reported in other target organ involvement? We investigated the associations of two abnormal findings on brain magnetic resonance imaging suggestive of a vascular etiology, low intense foci (lacunae), and periventricular hyperintense lesions on T,-and Tj-weighted images, with both office and average daily blood pressure values in a population of 73 healthy normotensive and hypertensive elderly individuals (70 ± 6 years old). Lacunae were detected in 34 subjects (47%); the number per subject ranged from 0 to 19 and was significantly correlated with advancing age. Furthermore, these changes were supposedly related to the average of noninvasive ambulatory (24-hour and during awake and asleep periods) pressure recordings but not to office pressures. The grade of periventricular hyperintensity was also significantly associated with advancing age and the average of ambulatory systolic pressure recordings, particularly during sleep, but not with office blood pressure. In comparisons of normotensive, "office hypertensive," and hypertensive subgroups, abnormalities on magnetic resonance imaging were appropriate to the level of the 24-hour blood pressure measurements but not to that of clinic pressure. In hypertensive patients, the presence of electrocardiographic evidence of left ventricular hypertrophy was also associated with greater abnormalities on magnetic resonance imaging. We conclude that ambulatory blood pressure monitoring is superior to casual pressure measurements in predicting latent cerebrovascular disease, which is unexpectedly common in apparently healthy elderly subjects. {Hypertension 1990;16:692-699) I t is well known that pressures measured in the office or clinic may not be representative of the patient's blood pressure throughout the day. 1The correlations between target organ damage and different measures of blood pressure have been compared in several studies. 2^ In the heart, ambulatory blood pressure measurements have given better correlations than clinic readings with left ventricular hypertrophy as evaluated by electrocardiogram, chest x-ray, and echocardiography.4 -7 Hypertensive retinopathy 48 was also found to correlate more closely with ambulatory pressures than with casual pressures. These results suggest that the adverse effects of blood pressure on the heart and peripheral vessels (including the optic fundi) depend on the average level of pressure over time. To date, however, there

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“…La disponibilidad de la MAPA ha permitido conocer la reacción de bata blanca, es decir la elevación de la presión arterial secundaria a la reacción de alerta ocasionada por la misma toma de la presión arterial, tanto cuando la toma un médico como cuando la toma el personal de enfermería (14)(15)(16). La presencia de discordancias entre mediciones de PA realizadas en consultorio y mediciones efectuadas en casa o fuera del consultorio en algunos pacientes es un tema comentado desde hace tiempo en la literatura científica (17).…”

Section: Resultsunclassified

Monitorización ambulatoria de presión arterial (MAPA) en enfermos jóvenes

Robles

Tristancho

Cancho

et al. 2001

An. Med. Interna (Madrid)

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INTRODUCCIÓNLa MAPA es un elemento diagnóstico de extraordinario interés para la enfermedad más común que podemos encontrar en nuestra sociedad. Su uso se ha generalizado progresivamente en la práctica clínica tanto general como especializada. Además de sus utilidades desde el punto de vista experimental y para la investigación clínica (1,2), se han definido dos usos esenciales para la técnica. El primero de ellos es la confirmación del diagnóstico de HTA (o dicho al revés, la negación del diagnóstico 23 [0212-7199(2001) 18: 6; pp 305-308] ANALES DE MEDICINA INTERNA

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Noninvasive Ambulatory Blood Pressure Monitoring During Clinic Visit in Elderly Hypertensive Patients

Cited by 16 publications

References 24 publications

Power Spectral Analysis of Spontaneous Blood Pressure and Heart Rate Variability in Elderly Hypertensives.

Power Spectral Analysis of Spontaneous Blood Pressure and Heart Rate Variability in Elderly Hypertensives.

Silent cerebrovascular disease in the elderly. Correlation with ambulatory pressure.

Monitorización ambulatoria de presión arterial (MAPA) en enfermos jóvenes

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