Task Force III: Target-organ damage, morbidity and mortality

Verdecchia, Paolo; Clément, Denis; Fagard, R; Palatini, P; Parati, G.

doi:10.1097/00126097-199912000-00004

Cited by 70 publications

(78 citation statements)

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“…Non-Dippers were investigated in the study because (1) they have been identified as nonresponders to exercise 12 and (2) non-dipping hypertension is associated with more serious end-organ damage and higher incidence of cardiovascular complications than Dippers. 11 A single bout of exercise was chosen for this study because it may be the initial step to investigate the effectiveness of exercise on blood pressure reduction in populations previously identified as nonresponders. 24 Training studies may not be justified without demonstrating an acute response first.…”

Section: Discussionmentioning

confidence: 99%

“…Endurance exercise training lowers blood pressures in hypertensive patients 8À10 2. Nocturnal nondipping hypertensive patients (Non-Dippers: defined as o10% reduction in average nighttime blood pressure compared to average daytime blood pressure) 11 have been identified among the nonresponders to exercise training 12 3. A more effective exercise programme for Non-Dippers may be warranted 4.…”

Section: Ambulatory Blood Pressure Monitoringmentioning

confidence: 99%

“…[4][5][6][7] Even though endurance exercise training lowers blood pressures in hypertensive patients, [8][9][10] approximately 25% of the hypertensive patients do not exhibit blood pressure reduction associated with exercise training. 8 Hypertensive patients who do not exhibit nocturnal dipping (Non-Dippers: defined as o10% reduction in average nighttime blood pressure compared to average daytime blood pressure) 11 have been identified among the nonresponders to exercise training. 12 Nami et al 12 reported that aerobic exercise training failed to reduce blood pressure in Non-Dippers while it did reduce blood pressure in hypertensive patients who exhibited nocturnal dipping (Dippers).…”

Section: Introductionmentioning

confidence: 99%

“…12 Non-dipping hypertension is associated with a higher degree of cardiovascular complications and more serious end-organ damage than Dipping hypertension. 11 Thus, a more effective exercise programme for Non-Dippers may be warranted.…”

Section: Introductionmentioning

confidence: 99%

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Time of day for exercise on blood pressure reduction in dipping and nondipping hypertension

2005

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Time of day (TOD) for exercise may influence blood pressure (BP) reduction in hypertension because of the diurnal variation of BP and the duration of BP reduction following a single bout of exercise. The purpose of this study was to observe the effects of TOD for exercise on ambulatory blood pressure reduction in dipping (n ¼ 5) and nondipping (n ¼ 9) hypertension (o10% drop in nighttime BP (BP night )). Hypotheses: (1) evening exercise (PM ex ) would exhibit a greater BP night reduction in NonDippers than Dippers, (2) morning exercise (AM ex ) would exhibit similar daytime BP (BP day ) reduction in Dippers and Non-Dippers, (3) AM ex would exhibit greater 24 h BP (BP 24 h ) reduction than PM ex in Dippers, and (4) AM ex and PM ex would exhibit similar BP 24 h reduction in NonDippers. BP responses to AM ex (0600-0800 h; 30 min at 50% VO 2peak ) and PM ex (1700-1900 h) were compared to each control day in a randomized design. Systolic (S) and diastolic (D) BP were averaged for BP 24 h , BP day , and BP night . A two-way ANOVA (dipping X time of exercise) using BP reduction with repeated measures were performed at Po0.05. Findings: (1) Non-Dippers respond to exercise despite of TOD for exercise, (2) PM ex exhibited a greater SBP night reduction in Non-Dippers than Dippers, (3) AM ex exhibited similar SBP day reductions in Dippers and Non-Dippers, and (4) AM ex and PM ex exhibited similar SBP 24 h reduction in Dippers and NonDippers. Dippers and Non-Dippers respond differently to TOD for exercise. The duration of the BP reduction persists up to 24 h after exercise.

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Section: Discussionmentioning

confidence: 99%

Section: Ambulatory Blood Pressure Monitoringmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Time of day for exercise on blood pressure reduction in dipping and nondipping hypertension

2005

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“…In recent years, 24-h ambulatory monitoring of BP has become increasingly valuable in facilitating detection of WCEs and RWCEs, and there is some indication that ambulatory methods of measuring BP are more closely associated with cardiovascular disease outcomes and target organ pathology than BP measures made in the clinic. [10][11] However, the use of ambulatory instrumentation represents an additional time demand for the physician and cost to the patient and/or health-care system that needs to purchase, maintain, calibrate and replace monitoring units. The costs of ambulatory BP monitoring can only be covered by insurance carriers if the practicing physician reasonably suspects white coat hypertension, a consideration in which definitive indicators are lacking.…”

Section: Introductionmentioning

confidence: 99%

Detecting white coat and reverse white coat effects in clinic settings using measures of blood pressure habituation in the clinic and patient self-monitoring of blood pressure

et al. 2007

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To examine the utility of blood pressure (BP) habituation within and across multiple clinic visits and patientdetermined home BP monitoring for detecting white coat (WCE) and reverse white coat effects (RWCE) commonly observed in medical settings, 54 patients undergoing evaluation for hypertension in an internal medicine group practice were categorized according to the magnitude of differences between systolic BP (SBP) and diastolic BP (DBP) obtained in the clinic and through ambulatory BP monitoring. BPs were measured four times during three separate clinic visits, during a 1-week home BP monitoring period, and during a single 24-h ambulatory monitoring period. Patients whose mean clinic and average daytime BPs were within 75 mm Hg were categorized as having stable BP; patients whose clinic BPs were 45 mm Hg of their daytime BPs were categorized as showing a WCE and patients whose average daytime BPs were 45 mm Hg of their clinic BPs were categorized as showing a RWCE. Results revealed that degree of habituation occurring between the first and third clinic visits significantly predicted magnitude of both the WCE and RWCE for SBP, with greater habituation being associated with the WCE and lesser habituation associated with the RWCE. Greater SBP habituation within clinic visits was associated with the WCE for SBP and greater DBP habituation within clinic visits was associated with the WCE for DBP. Lesser DBP habituation within clinic visits was associated with the RWCE for both SBP and DBP. Home BP monitoring did not contribute to predicting either WCE or RWCE.

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The reproducibility of ethnic differences in the proportional awake–sleep blood pressure decline among women

Berge-Landry

Bovbjerg

James

2010

American J Hum Biol

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A growing body of evidence indicates that African Americans (AA), on average, have a smaller proportional decline in blood pressure (BP) from waking to sleep than European Americans (EA), but this difference is largely based on correlational data from a single assessment day. The persistence of this difference over repeated sampling is not well established. The purpose of this study was to evaluate whether ethnic differences in the awake-sleep BP decline between AA and EA persisted over three monthly assessments. The subjects were 47 AA (age = 39.7 +/- 8.7) and 92 EA (age = 37.4 +/- 9.2) normotensive women. Subjects had 24-h ambulatory BP monitoring done on midweek workdays at 1-month intervals for three consecutive months. The proportional decline in BP was calculated as follows: (average awake - average sleep)/average sleep. The persistence of ethnic differences was evaluated using repeated-measures ANCOVA and by examining Bland-Altman plots. The ANCOVA results revealed that overall, the proportional decline of AA women was less than that of EA women for both SBP (P < 0.038) and DBP (P < 0.083), consistent with previous research, and that there were also no significant ethnic differences by monthly assessment. Bland-Altman plots revealed that overall and by ethnicity, the proportional decline in BP among individual subjects over the 3 months was also reproducible. These results suggest that the ethnic difference in awake-sleep BP between AA and EA women persists over time and that the awake-sleep decline in BP among individuals, whether AA or EA, is also reproducible.

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Task Force III: Target-organ damage, morbidity and mortality

Cited by 70 publications

References 0 publications

Time of day for exercise on blood pressure reduction in dipping and nondipping hypertension

Time of day for exercise on blood pressure reduction in dipping and nondipping hypertension

Detecting white coat and reverse white coat effects in clinic settings using measures of blood pressure habituation in the clinic and patient self-monitoring of blood pressure

The reproducibility of ethnic differences in the proportional awake–sleep blood pressure decline among women

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