Morning Blood Pressure Surge, Dipping, and Risk of Coronary Events in Elderly Treated Hypertensive Patients
| Autor: | Sante D. Pierdomenico, Francesca Coccina, Anna M Pierdomenico, Roberta Di Tommaso, Ettore Porreca, Franco Cuccurullo, Silvio Di Carlo |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Ambulatory blood pressure Population Blood Pressure Coronary Artery Disease 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences Age Distribution 0302 clinical medicine Internal medicine Internal Medicine medicine Humans Prospective Studies 030212 general & internal medicine education Antihypertensive Agents Aged Morning Aged 80 and over education.field_of_study Coronary event business.industry Proportional hazards model Incidence Hazard ratio Age Factors Blood Pressure Monitoring Ambulatory Middle Aged Prognosis Confidence interval Circadian Rhythm Blood pressure Italy Hypertension Cardiology Female business Follow-Up Studies |
| Zdroj: | American Journal of Hypertension. 29:39-45 |
| ISSN: | 1941-7225 0895-7061 |
| DOI: | 10.1093/ajh/hpv074 |
| Popis: | BACKGROUND The independent prognostic significance of morning surge (MS) of blood pressure (BP) is not yet clear. We investigated the association between MS of systolic BP and risk of coronary events in elderly treated hypertensive patients. METHODS The occurrence of coronary events was evaluated in 1,191 elderly treated hypertensive patients (age range 60-90 years). Subjects were divided according to tertiles of MS of systolic BP of the population as a whole, by dipping status and by group-specific tertiles of MS of systolic BP in dippers and nondippers. RESULTS During the follow-up (9.1 ± 4.9 years, range 0.4-20 years), 120 coronary events occurred. In the population as a whole, coronary event risk was not significantly associated with tertiles of MS of systolic BP, whereas nondippers were at higher risk than dippers. When nondippers and dippers were analyzed separately, by group-specific tertiles of MS of systolic BP, coronary event risk was associated with MS of systolic BP in dippers but not in nondippers. After adjustment for various covariates, Cox regression analysis showed that dippers in the third tertile (>23 mm Hg) of MS of systolic BP (hazard ratio 1.912, 95% confidence interval 1.048-3.488, P = 0.03) and nondippers (hazard ratio 1.739, 95% confidence interval 1.074-2.815, P = 0.02) were at higher coronary event risk than dippers with MS of systolic BP |
| Databáze: | OpenAIRE |
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