The effects of nocturnal dipping on cardiovascular outcomes and proteinuria in essential hypertensive patients

Selçoki, Yusuf; Uz, Burak; Baybek, Nuket; Akçay, Ali; Eryonucu, Beyhan

doi:10.2478/s11536-008-0009-y

Cited by 3 publications

(3 citation statements)

References 44 publications

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“…BP measurements without a fall in nocturnal BP are called non-dipping and with a fall in nocturnal BP is called dipping. 8 Non-dipper patients with essential hypertension are prone to some diseases like left ventricular hypertrophy and stroke probably because of exposing to higher BP levels for 24 h. 8,9 Excessive lowering of BP levels in dipping patients also increase risk for some diseases like cardiac ischemia and silent cerebrovascular damage. [10][11][12][13] Color Doppler imaging is a non-invasive and reproducible imaging method.…”

Section: Introductionmentioning

confidence: 99%

Ocular pulse amplitude and retrobulbar blood flow change in dipper and non-dipper individuals

Karadağ

Keskin

Köktener

et al. 2011

Eye

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Purpose To evaluate ocular pulse amplitude (OPA), IOP values, and hemodynamic changes in the ophthalmic artery, central retinal artery, and short posterior ciliary artery in dipper and non-dipper patients. Methods A total of 59 right eye measurements of healthy subjects with normotensive were included to the study. Ambulatory blood pressure (BP) monitoring measurement (ABPM), Doppler imaging, and OPA measurements were performed in the same day. The patients in which systolic BP decreased during the nocturnal time by 10% of the diurnal BP or more were called dippers. A patient whose nocturnal systolic BP fell by o10% or even rose was defined as non-dipper.Color Doppler imaging was used for blood flow velocity assessment of ophthalmic, central retinal, and posterior ciliary arteries. For each artery, peak systolic and end-diastolic velocities (PSV and EDV, respectively), resistive index (RI), and pulsalite index (PI) were automatically calculated by the machine. Mean IOP and OPA values were calculated after three consecutive measurements. Results The mean OPA in non-dipper patients was significantly lower compared with that of dipper patients (P ¼ 0.011). There was no significant difference in IOP levels between groups. There was no significant difference in the PSV, EDV, RI, and PI in the ophthalmic, posterior ciliary, and central retinal arteries between the groups. Conclusion Our study demonstrated that OPA level in non-dippers is lower than dippers. This may give additional information about the effect of BP changes on OPA values.

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Section: Introductionmentioning

confidence: 99%

Ocular pulse amplitude and retrobulbar blood flow change in dipper and non-dipper individuals

Karadağ

Keskin

Köktener

et al. 2011

Eye

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“…Also the urinary protein excretion increase was higher in the non-dipper group than in the dipper group. In Yusuf Selcoki et al [13] study the spot urine creatinine ratio was significantly higher in the non-dipper group. In our study, we found that mean spot protein creatine ratio in dippers was 0.17 and in non-dippers 3.88 (p=0.08).…”

Section: Discussionmentioning

confidence: 87%

Ambulatory Blood Pressure Monitoring in Young Hypertensive Patients

Swaroopa¹,

Ganesh²,

Anudeep³

et al. 2020

SJAMS

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Original Research ArticleBackground: Hypertension is one of the leading causes of the global burden of disease and is a major risk factor for cardiovascular disease, stroke and renal failure. Since younger patients are easily susceptible to reactive hypertension and may have low pre-test probability of hypertension, in this context we aimed at measuring Ambulatory blood pressure monitoring(ABPM) to differentiate true from white coat hypertension and to identify dippers and nondippers . Methods: A total of forty six newly diagnosed hypertensive patients based on clinic BP measurement from out-patient department with age ranging from 18-40years were included. All were subjected to ABPM by using ABPM-05 machine from Meditech Ltd. and Easy ABPM 1.1.1.0 as program. Results: The mean age of the subjects was 31.67±5.43 yrs, among them 35 were males and 11 were females. Out of total 46, 38 patients had true hypertension and 8 had white coat hypertension. Dipping was the most common (30) finding followed by non-dipping (16). Non dipping pattern is seen more in females (7 out of 11) than males. It is observed that the Haemoglobin levels in dippers was significantly higher as compared to subjects with non-dipping pattern (14.4 vs 12.2, p=0.001). Serum albumin were also higher in dippers when compared to non-dippers (4.33g/dl vs 3.84 g/dl, p=0.04). Conclusion: Ambulatory blood pressure monitoring is a very important tool to identify white coat hypertension, where they may not benefit from immediate antihypertensive treatment so as to avoid overtreatment and also identify non dippers which was sought to be a cardio-vascular risk factor.

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“…Recent results have indicated that an increased risk for SAHS is highly prevalent when assessed by a special Berlin questionnaire, and it is frequently associated with resistant hypertension [38]. ABPM should be evaluated in patients with hypertension to assess and prevent risk of morbidity and mortality [39]. In patients with sleep apnea.…”

Section: 1mentioning

confidence: 99%

Blood pressure increase detected by ambulatory monitoring correlates with hypoxemia reflecting sleep apnea severity

et al. 2009

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AbstractAmbulatory blood pressure monitoring and parallel polysomnographic study were performed in 116 adult males divided into 6 groups. Thirty blood-pressure (BP) and polysomnographic variables were measured to test their usefulness for screening for both arterial hypertension and sleep apnea-hypopnea syndrome (SAHS). The development of severe breathing disorders and hypoxemia during sleep was attributed to SAHS, when compared with measurements in healthy controls and in patients with arterial hypertension. Such disorders manifested as an increased apnea-hypopnea index, apnea index, duration of arterial oxygen saturation of less than 85%, and decrease of average arterial oxygen saturation that correlated with nocturnal average diastolic BP (p=0.0049, p=0.0027, p=0.049 and p=0.0457, respectively). These respiratory disorders resulted in various nocturnal, rather than diurnal, and diastolic and systolic BP variables. The acute antihypertensive effect of continuous positive airway pressure therapy for SAHS significantly reduced the episodes of apnea and hypopnea and the secondary component of hypertension caused by excessive sympathetic stimulation. For the SAHS-induced, dose-dependent component of hypertension that responded to continuous positive airway pressure, the following variables, in decreasing significance, were useful: nocturnal average systolic and diastolic BP and 24-hour average systolic and diastolic BP, as well as percent time elevation and mean blood pressure load. The monitoring of these variables could contribute to early diagnostic and prognostic stratification of complications and adequate therapy of the secondary component of hypertension caused by SAHS.

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The effects of nocturnal dipping on cardiovascular outcomes and proteinuria in essential hypertensive patients

Cited by 3 publications

References 44 publications

Ocular pulse amplitude and retrobulbar blood flow change in dipper and non-dipper individuals

Ocular pulse amplitude and retrobulbar blood flow change in dipper and non-dipper individuals

Ambulatory Blood Pressure Monitoring in Young Hypertensive Patients

Blood pressure increase detected by ambulatory monitoring correlates with hypoxemia reflecting sleep apnea severity

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