The Prognostic Effect of Circadian Blood Pressure Pattern on Long-Term Cardiovascular Outcome Is Independent of Left Ventricular Remodeling

被引:17
作者
Tadic, Marijana [1 ]
Cuspidi, Cesare [2 ,3 ]
Celic, Vera [4 ]
Pencic, Biljana [4 ]
Mancia, Giuseppe [5 ]
Grassi, Guido [5 ]
Stankovic, Goran [6 ]
Ivanovic, Branislava [6 ]
机构
[1] Charite Univ Med Berlin, Dept Internal Med & Cardiol, Campus Virchow Klinikum,Augustenburgerpl 1, D-13353 Berlin, Germany
[2] Univ Milano Bicocca, Clin Res Unit, Viale Resistenza 23, I-20036 Meda, Italy
[3] Ist Auxol Italiano IRCCS, Viale Resistenza 23, I-20036 Meda, Italy
[4] Univ Clin Hosp Ctr Dr Dragisa Misovic Dedinje, Dept Cardiol, Heroja Milana Tepica 1, Belgrade 11000, Serbia
[5] Univ Milano Bicocca, Dept Med & Surg, Clin Med, I-20126 Milan, Italy
[6] Clin Ctr Serbia, Clin Cardiol, Koste Todorovic 8, Belgrade 11000, Serbia
关键词
hypertension; left ventricle; hypertrophy; diastolic dysfunction; non-dipping; reverse dipping; REVERSE DIPPING PATTERN; AMERICAN-SOCIETY; EUROPEAN ASSOCIATION; DIASTOLIC FUNCTION; ECHOCARDIOGRAPHY; RECOMMENDATIONS; MORTALITY; QUANTIFICATION; METAANALYSIS; HYPERTENSION;
D O I
10.3390/jcm8122126
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We aimed to investigate the predictive value of 24 h blood pressure (BP) patterns on adverse cardiovascular (CV) outcome in the initially untreated hypertensive patients during long-term follow-up. This study included 533 initially untreated hypertensive patients who were involved in this study in the period between 2007 and 2012. All participants underwent laboratory analysis, 24 h BP monitoring, and echocardiographic examination at baseline. The patients were followed for a median period of nine years. The adverse outcome was defined as the hospitalization due to CV events (atrial fibrillation, myocardial infarction, myocardial revascularization, heart failure, stroke, or CV death). During the nine-year follow-up period, adverse CV events occurred in 85 hypertensive patients. Nighttime SBP, non-dipping BP pattern, LV hypertrophy (LVH), left atrial enlargement (LAE), and LV diastolic dysfunction (LV DD) were risk factors for occurrence of CV events. However, nighttime SBP, non-dipping BP pattern, LVH, and LV DD were the only independent predictors of CV events. When all four BP pattern were included in the model, non-dipping and reverse dipping BP patterns were associated with CV events, but only reverse-dipping BP pattern was independent predictor of CV events. The current study showed that reverse-dipping BP pattern was predictor of adverse CV events independently of nighttime SBP and LV remodeling during long-term follow-up. The assessment of BP patterns has very important role in the long-time prediction in hypertensive population.
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页数:9
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