Morning surge of blood pressure in the elderly is more prominent than younger patients in the treatment and ambulatory blood pressures (TRAP) study
Makaleler > Tam Makale · 2001
Yazarlar: N Koylan
American Journal of Hypertension, Uluslararası, Wos, 2001, cilt 14, ss A52-A52
DOI: 10.1016/s0895-7061(01)02102-1
Özet
Morning surge in hypertension is responsible for many acute cardiovascular events and needs special care during treatment. To investigate the morning surge of blood pressure (BP), 568 patients (pts) aged 18 to 80 years with treated essential hypertension (EH) were evaluated by ambulatory blood pressure monitoring (ABPM). Pts were selected from 30 hypertension centers. Inclusion crieterion was being under control with drug treatment at least for 3 months. Pts with secondary hypertension, uncontrolled hypertension, pregnancy, heart, kidney or liver failure, major surgery, acute coronary event, coronary intervention or stroke for the last 6 months, atrial fibrillation or other types of major arrhythmias, hypertrophic cardiomyopathy and electrolyte disturbances with clinical significance, the use of digoxin, nitrates, KCL, lithium or major antidepressants were excluded. ABPM measurements were performed every 30 minutes between 07:00 AM and 11:00 PM (awake time(AT)), and every hour between 11:00 PM and 07:00 AM (sleep time(ST)). BP targets are accepted as 14/90 mmHg or less for office BP, 130/85 mmHg or less for awake time ABPM and 120/80 mmHg or less for sleep time ABPM. Patients having age of 65 years or older were regarded as elderly. Diastolic BP measurements in elderly patients were significantly lower than the others in almost all measurements at ABPM as well as day and night means. On the other hand, systolic BP's measured at 06:00 AM, 07:00 AM and 07:30 AM were significantly higher in the elderly (p=0,016; p=0,009; p=0,007 respectively). The difference between the other systolic BP measurements and systolic BP variability were insignificant. There were no significant differences between the day and night means of systolic BP or drug use between elderly and the others. These results demonstrate that elderly people need more caution during treatment and the treatment must cover the next day morning. Grant/Research Support - Boehringer Ingelheim Ilaq Pic. A.S.