Autonomic nervous system activity in dipper and non-dipper essential hypertensive patients. What about sex differences?
| Autor: | Siché Jp, Stéphanie Ragot, Daniel Herpin, Jean Michel Mallion, Pierre Ingrand |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Ambulatory blood pressure Physiology Autonomic Nervous System Internal medicine Photoplethysmogram Heart rate Internal Medicine Medicine Humans Circadian rhythm Photoplethysmography Aged Sex Characteristics biology Dipper business.industry Blood Pressure Monitoring Ambulatory Middle Aged biology.organism_classification Circadian Rhythm Autonomic nervous system Endocrinology Blood pressure Echocardiography Ambulatory Hypertension Multivariate Analysis Cardiology Regression Analysis Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of hypertension. 17(12 Pt 2) |
| ISSN: | 0263-6352 |
| Popis: | Objectives To compare the autonomic nervous system activity indexes obtained from photoplethysmography in dipper and non-dipper hypertensive patients and to seek a potential influence of sex on the relation between autonomic nervous system and the nocturnal decrease in blood pressure. Methods We studied 245 hypertensive patients, who underwent 24 h ambulatory blood pressure monitoring (ABPM), photoplethysmographic blood pressure recording, and echocardiography. Non-dipping patients were defined as those whose nocturnal decrease in systolic blood pressure (SBP), diastolic blood pressure (DBP), or both was less than 10% of the daytime blood pressure. Spectral powers of SBP, DBP and heart rate were obtained from photoplethysmographic recordings over three main frequency bands: very low frequency (0.005-0.05 Hz), low frequency (0.05-0.14 Hz) and high frequency (0.14-0.40 Hz). Results Because their ABPM were normal (less than 135/ 85 mmHg; n = 33), of poor quality (n = 22) or performed at a period too far from the photoplethysmographic recording (n = 17), 66 patients were excluded from the analysis. The remaining 179 patients comprised 117 dippers and 62 non-dippers. The groups did not differ regarding clinical and echocardiographic characteristics, irrespective of sex. Low-frequency spectral powers were significantly lower in non-dippers than in dippers, whatever the signal, whereas high-frequency spectral powers did not differ significantly between the groups. The nocturnal decrease in blood pressure increased with increasing low-frequency spectral powers, but was negatively correlated with high-frequency spectral powers. Multivariate linear regression analysis identified low-frequency spectral power of SBP and clinic DBP as independent factors determining the decrease in blood pressure. After adjustment for all significant covariates, the odds of being a non-dipper did not differ between men and women. Conclusion A non-dipper profile seemed to be associated, in both men and women, with lower low-frequency spectral powers compared with those in dippers, suggesting impaired sympathetic arterial modulation. |
| Databáze: | OpenAIRE |
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