Nocturnal Blood Pressure Dipping is Abolished in Old-Elderly Hospitalized Patients.

Autor: Salvo F; Division of Internal Medicine, Poveri Infermi Hospital, Loc. San Bernardino, 4, 17073, Ceva, CN, Italy. fre1988s@gmail.com., Lonati C; Department of Internal Medicine and Hypertension Center, S. Giuseppe Hospital, Via San Vittore, 12, 20123, Milan, Italy., Berardi M; Division of Internal Medicine, Poveri Infermi Hospital, Loc. San Bernardino, 4, 17073, Ceva, CN, Italy., Errani AR; Division of Internal Medicine, Poveri Infermi Hospital, Loc. San Bernardino, 4, 17073, Ceva, CN, Italy., Muzzulini CL; Division of Internal Medicine, Poveri Infermi Hospital, Loc. San Bernardino, 4, 17073, Ceva, CN, Italy., Morganti A; Centre of Clinical Physiology, Hypertension, Policlinico Hospital, University of Milan, Via Francesco Sforza, 25, 20122, Milan, Italy.
Jazyk: angličtina
Zdroj: High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension [High Blood Press Cardiovasc Prev] 2017 Dec; Vol. 24 (4), pp. 413-417. Date of Electronic Publication: 2017 Jul 22.
DOI: 10.1007/s40292-017-0224-1
Abstrakt: Introduction: During sleep there is reduction of blood pressure (BP) caused by a decrease of the sympathetic nervous tone. This nocturnal "dipping" phenomenon, assessable with ambulatory blood pressure monitoring (ABPM), is blunted with increasing age.
Aim: To assess the effect of hospitalization on night-time BP fall in old-elderly patients.
Methods: We analysed 78 ABPM of old-elderly hospitalized patients (mean age 91 ± 0.5 years) and those of 18 outpatients as control group. The nocturnal BP fall was assessed calculating: the dipping value (DV) i.e. the difference between mean diurnal systolic BP (mDSBP) and mean nocturnal systolic BP (mNSBP) and the "dipping pattern" i.e. mNSBP/mDSBPx100.
Results: Hospitalized patients showed a lower rate of normal dipping patterns (9 vs. 39%), an higher rate of reverse dippers (59 vs. 28%; p < 0.05) and a lower DV (-0.9 ± 1 vs. 9 ± 4 mmHg; p < 0.05) than patients of control group. At multivariate regression analysis including age, gender and hospitalization, DV was significantly correlated only with the hospitalization (β -0.3, t -2.9; p < 0.05).
Conclusions: In old-elderly hospitalized patients nocturnal BP fall is abolished. This enhancement of the age related reduction of nocturnal BP dipping may be due to the stress associated with hospital environment.
Databáze: MEDLINE
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