You are here

GENÇ NORMOTANSİF VE HİPERTANSİF BİREYLERDE AYAKTAN KAN BASINCI İZLEMİ SONUÇLARI

RESULTS OF AMBULATORY BLOOD PRESSURE MONITORING IN NORMOTENSIVE AND HYPERTENSIVE SUBJECTS YOUNGSTERS

Journal Name:

Publication Year:

Abstract (2. Language): 
Importance of ambulatory blood pressure monitoring (ABPM) has been expanded in the evaluation of hypertensive patients in clinical practice and scientific investigations. Although studies with ABPM have been conducted on both patients and healthy subjects in various ages, sexes and races; "normal" blood pressure (BP) definition has not been made with consensus, in this study, BPs and diurnal BPs in normotensive and hypertensive subjects between 16-35years have been investigated with ABPM. One hundred thirty four patients with essential hypertension (67 males, 67 females) and 137 normotensive healthy subjects (67 males, 70 females) between 16-35years were enrolled in the study (n:271). Medical history has been obtained, physical examination performed, routine laboratory tests assessed and then 24-hour noninvasive ABPM has been used to measure BP. BP measurements with ABPM was lower than office BP measurements in all subjects (p<0.001). In normotensive subjects mean BP measurements in office and with ABPM were lower in women than men (p<0.001). The mean ratio of dipper male hypertensive patients (41.1%) was significantly lower than dipper female hypertensive patients (55.8%) (p<0.05). Mean body mass indices (BMI) of hypertensive males and females were significantly higher than that of normotensive subjects (p<0.001). Noninvasive ABPM is a practical method to investigate variations in diurnal BPs which could be considered as an additional cardiovascular risk factor in hypertensive patients.
Abstract (Original Language): 
Klinik pratikte ve bilimsel araştırmalarda hipertansif hastaların değerlendirilmesinde ayaktan kan basıncı izlemi (AKBİ) uygulamasının önemi giderek artmaktadır. AKBİ kullanılarak değişik yaş, cins ve ırktaki hasta ve sağlıklı grupları içeren çalışmalar yapılmakla birlikte normal kan basıncını (KB) tanımlama konusunda tam bir fikir birliği sağlanamamıştır. Bu çalışmada, 16-35 yaş grubundaki normotansif veya hipertansif olan bireylerin AKBİ uygulaması ile elde edilen KB değerlerini ve diürnal KB değişimini incelemek amaçlanmıştır. Çalışmaya yaşları 16-35 arasında olan 134ü esansiyelhipertansiyonlu (erkek:67, kadm:67) ve 137'si sağlıklı normotansif olan (erkek:67, kadın:70) toplam 271 birey alınmıştır. Bireylerin tıbbi anamnezi alınıp sistemik muayeneleri ile standart laboratuar testleri yapılmış ve 24 saat süreyle KB ölçmek için noninvaziv AKBİ uygulanmıştır. Tüm çalışma grubunda AKBİ uygulaması ile elde edilen KB değerleri poliklinikte ölçülen KB değerlerinden daha düşük bulunmuştur (pO.001). Normotansif grupta poliklinikte ölçülen ve AKBİ uygulaması ile elde edilen ortalama KB değerleri kadınlarda erkeklerin ortalama kan basıncı değerlerinden düşük saptanmıştır (pO.001). Erkek hipertansif grupta dipper yüzdesi % 41.1 iken, kadın hipertansif grupta bu oran % 55.8 olarak saptanmış ve aradaki fark anlamlı bulunmuştur (p0.05). Hipertansif kadın ve erkeklerin vücut kitle indeksi (VKİ) ortalamaları normotansiflere göre ileri derecede anlamlı yüksek bulunmuştur (p< 0.001). Noninvaziv AKBİ, diürnal KB değişimlerini incelemenin en pratik yolu olup bu özelliği ile hipertansif bireylerde bilinen kardiyovasküler risk faktörlerini saptayan diğer yöntemlerle birlikte kullanılmasının faydalı olacağı düşünülmektedir
FULL TEXT (PDF): 
115-122

REFERENCES

References: 

1.
Akpolat
, T. : Hipertansiyonda temel bilgiler ve tedavi prensipleri. Aktüel Tıp Dergisi, 5 (5): 1-7, 2000.
2. Guidelines Subcommitee of the World
Healt
h Organization-Internetional Society of Hypertension (WHO-ISH): 1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. J. Hypertens., 17: 151-183, 1999.
3.
Kaplan
, N.M.: Kan basıncı ölçülmesi. Klinik Hipertansiyon, Kaplan, N.M. (ed), İstanbul, Turgut yayıncılık. 1998, 19-39.
4.
Korkmaz
, M.: Hipertansiyon epidemiyolojisi. Hipertansiyon, Arık, N., Korkmaz, M. (eds.), 2. baskı, İstanbul, Format matbaacılık. 1999, 15-19.
5. Ulusal Hipertansiyon Tedavi ve Takip Kılavuzu. Türk Kardiyoloji Derneği, 2000.
6.
Kaplan
, N.M.: Toplum genelinde hipertansiyon. Klinik Hipertansiyon, Kaplan, N.M. (ed), İstanbul, Turgut
yayıncılık. 1998, 1-18.
7. Mancia, G.: Ambulatory blood pressure monitoring for antihypertensive drug studies and combination treatment. Combination Drug Therapy for Hypertension, Opie, H., Messerli, F.H. (eds), Philadelphia, Lippincott-Raven Publishers. 1997, 11¬23.
8. Sega, G., Bravi, C., Cesana, G., Valagussa, F., Mancia, G., Zanchetti, A.: Ambulatory and blood pressure normality: The Pamela Study. J. Cardiovasc.
Pharmacol., 23 (suppl. 5): S12-S15, 1994..
9.
Staessen
, J.A., O'Brien, E.T., Amery, A.K.: Ambulatory blood pressure in normotensive and hypertensive subjects: results from an international database. J. Hypertens., 12(suppl 7): S1-S12, 1994.
10. Verdecchia, P. Schillacci, G., Porcellati, C: Dippers versus non-dippers. J. Hypertens. 9 (suppl 8): S42-S44,
1991.
11. Chase, H.P., Garg, S.K., Icaza, G., Carmain, J.A., Walravens, C.F., Marshall, G.: 24-h ambulatory blood pressure monitoring in healthy young adult anglo, hispanic, and african-american subjects. Am. J.
Hypertens., 10(1): 18-23, 1997.
12. Gosse P, Promax H, Durandet P, Clementy J: 'White Coat' Hypertension No Harm for the Heart. Hypertension 1993; 22(5): 766-770
13. Staessen, J.A., Bieniaszewski, L., O'Brien, E.T., Fagard, R.: What is normal blood pressure on ambulatory monitoring? Nephrol. Dial. Transplant., 11:
241-245, 1996.
14. Myers, M.G., Haynes, R.B., Rabkin, S.W.: Canadian hypertension society guidelines for ambulatory blood pressure monitoring. Am. J. Hypertens., 12: 1149-1157,
1999.
15. Swales, J.D.: Epidemiology of blood pressure. Manual of Hypertension, Swales JD (ed), Oxford,Blackwell
science. 1995, 1-12.
16. Schillaci, G., Verdecchia, P., Borgioni, C. : Predictors of diurnal blood pressure changes in 2042 subjects with essential hypertension. J. Hypertens. 14(10): 1167¬1173, 1996.
17. Zachariah, P.K., Sheps, S.G., Bailey, K.R., Wiltgen,
CM., Moore, A.G.: Age-relatedcharacteristics of ambulatory blood pressure load and mean blood pressure in normotensive subjects. JAMA, 265(11):
1414-1417, 1991.
18. Khoury, S., Yarows, S.A., O'Brien, T.K., Sowers, J.R.:
Ambulatory blood pressure monitoring in a nonacademic setting, Effects of age and sex. Am. J.
Hypertens., 5: 616-623, 1992.
19. Lerman, C.E., Brody, D.S., Hui, T.: The white coat hypertension response: prevalence and predictors. J.
Gen. Intern. Med., 4:226-231,1989.
20. Siegel, W.L., Blumenthal, J.A., Divine, G.W.:
Physiological, psycological and behavioral factors and white coat hypertension. Hypertension, 16: 140-146,
1990.
21. Palatini, P., Penzo, M., Racioppa, A.: Clinical relevance of nighttime blood pressure and daytime blood pressure variability. Arch. Intern. Med., 152:
1855-1860, 1992.
22. Marchesiv, E., Perani, G., Falaschi, F., Negro, C, Catalano, O., Ravetta, V., Finardi, G.: Metabolic risk factors in white coat hypertensives. J. Hum. Hypertens.,
8; 475-479, 1994.
23. Verdecchia, P., Schillaci, G., Borgioni, C, Ciucci, A., Pede, S., Porcellati, C: Ambulatory pulse pressure: A potent of total cardiovascular risk in hypertension.
Hypertension, 32: 983-988, 1998.
24. Verdecchia, P., Schillaci, G., Boldrini, F., Zampi, [., Pocellati, C: Variability between current definitions of ' Normal' ambulatory blood pressure. Hypertension, 20
(4): 555-562, 1992.
25. Pickering TG: Diurnal Rhythms and Other Sources of Blood Pressure Variability in Normal and Hypertensive Subjects. In Hypertension. Laragh JH, Brenner BM
(eds), New York, Raven press, vol 2, 1990, 1397-1405.
26. Verdecchia, P.: Prognostic value of ambulatory blood pressure: current evidence and clinicalimplications.
Hypertension, 35: 844-851, 2000.
27. Mallion, J.M., Baguet, J.P., Siche, J.P., Tremel, F.,
Gaudemaris, R.: Clinical value of ambulatory blood pressure monitoring. J. Hypertens., 17(5): 585-595,
1999.
28. Mochizuki, Y., Okutani, M., Donfeng, Y., Iwasaki, H., Takusagawa, M., Kohno, I., Mochizuki, S., Umetani,
121
K., Ishii, H., Ijiri, H., Komori, S., Tamura, K.: Limited reproducibility of circadian vaariation in blood pressure dippers and nondippers. Am. J. Hypertens., 11: 403¬409, 1998.
29. O'Brien, E., Sheridan, J., O'Malley, K.: Dippers and non-dippers (letter). Lancet, ii:397, 1988.
30. Stamler, R., Stamler, J., Riedlinger, W., Algera, G., Robers, R.: Weight and blood pressure. Findings in hypertension screening of 1 million Americans J. Am. Med., 240: 1607-1610, 1978.
31. Julius S, Mejia A, Jones K et al. 'White coat' versus 'sustained' borderline hypertension in Tecumseh, Michigan. Hypertension 1990;16:617-623
122

Thank you for copying data from http://www.arastirmax.com