Detection of silent myocardial ischemia in cases with dipper or nondipper hypertension
Makaleler > Tam Makale · 2001
Yazarlar: Sanem NALBANTGİL
American Journal of Hypertension, Uluslararası, Wos, 2001, cilt 14, ss A184-A184
DOI: 10.1016/s0895-7061(01)01637-5
Özet
It is well known that, in cases with hypertension (H) the prevalance of silent myocardial ischemia (SMI) is not uncommon. However up to date there is no knowledge about the prevalence of SMI in cases with dipper or non-dipper H. 280 patients (P) with moderate H had gone through ambulatory blood pressure monitoring. 82 of them showed non-dipper type H, and the rest showed dipper H. There were no differences between the two groups in terms of the patients office systolic and diastolic blood pressure, age, gender, duration of H, and blood chemistry (blood sugar, HDL-C, LDL-C, total cholesterol, trigliseride, BUN, electrolytes). All P went to ECG Holter test for 24 hours. ST segment depressions (>2 mm,>20 sec) without angina or its equivalants were established as SMI. 39 of 82 (47.5 %) P with non-dipper hypertension showed 94 episodes and 48 of 198 (24.2 %) P with dipper hypertension showed 77 episodes of SMI. There was significant difference (p<0.01) between two groups. On the otherhand the duration of total SMI was also longer in non-dipper group (67,2 ± 6.9 sec/per person vs 36,1 ± 6.2 sec/per person, p < 0.005). The range of SMI episodes according to time of the day were as follow: (See Table) It was concluded that the prevalance of SMI in cases with non-dipper H was significantly higher than in cases with dipper H. Secondly, the episodes of SMI were specially higher in the morning hours in cases with non-dipper H. This finding is also valuable because it is well known that some cardiac events are observed in the morning time.