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Gece Sistolik Kan Basıncı Yükselmelerinin Santral Hemodinamikler ve Arteriyel Sertleşme ile İlişkisi

Is Nocturnal Systolic Blood Pressure Rise Associated with Central Hemodynamics and Arterial Stiffness?

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2012
DOI: 
DOI 10.5262/tndt.2012.1003.06

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
OBJECTIVE: The aim of this study was to assess central hemodynamics and parameters of arterial stiffness of cases with nocturnal blood pressure rise. MATERIAL and METHODS: In this retrospective study, ambulatory blood pressure monitoring of 252 hypertensive patients was performed with the Mobil-O-Graph Arteriograph. RESULTS: 174 (%69.0) out of 252 patients were female and 78 (%31) were male and the mean age was 54.5±14.4. When Pearson’s correlation test was performed, the nocturnal systolic blood pressure (SBP) decline was associated with age (r=-0.169, p=0.008), diurnal pulse wave velocity (PWV) (r=-0.179, p=0.005), nocturnal diastolic blood pressure (DBP) decline (r=0.790, p<0.001), nocturnal central SBP (r=-0.410, p<0.001), and nocturnal augmentation index (Aix@75) (r=-0.215, p=0.001). When patients were divided into three groups as 10 % or more nocturnal SBP decline, less than 10 % nocturnal SBP decline and nocturnal SBP increase, there were statistically signifi cant differences regarding nocturnal pulse pressure (p<0.001), nocturnal DBP decline (p<0.001, nocturnal Aix@75 (p<0.001), and nocturnal peripheral resistance (p<0.001). CONCLUSION: We believe that strict follow up of conventional risk factors causing arterial stiffness in patients with less than 10 % nocturnal BP decline or increase and also the use of chronotherapy may be useful.
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Abstract (Original Language): 
AMAÇ: Bu çalışmanın amacı, gece KB yükselen hastaların santral hemodinamik ve arteriyel sertleşme göstergelerini incelemektir. GEREÇ ve YÖNTEMLER: Bu geriye dönük çalışmada, 252 hipertansif hastanın ayaktan kan basıncı (KB) izlemi Mobil-O-Graph Arteriograph cihazı kullanılarak yapıldı. BULGULAR: Toplam 252 hastanın 174’ü (%69,0) kadın, 78’i (%31) erkek ve yaş ortalamaları 54,5±14,4 idi. Pearson korelasyon testi uyguladığımızda; sistolik kan basıncında gece düşmeleri, yaş (r=-0,169, p=0,008), 24 saat (24s) sürecinde periferik direnç (r=-0,171, p=0,007), gündüz nabız dalga hızı (NDH) (r=-0,179, p=0,005), gece diyastolik kan basıncında (DKB) azalma (r=0,790, p<0,001), gece santral sistolik kan basıncı (SKB) (r=-0,410, p<0,001), gece santral DKB (r=-0,387, p<0,001), gece arttırma indeksi (Aix@75) (r=-0,215, p=0,001), gece periferal direnç (r=-0,321, p<0,001) ile ilişkiliydi. Hastaları sistolik kan basıncında gece düşmelerine göre; kan basıncında %10 ve daha fazla düşme olanlar, %10’dan daha az düşme olanlar ve gece kan basıncı artanlar olmak üzere üç gruba ayırdığımızda gruplar arasında hemoglobin düzeyi (p=0,033), gece nabız basıncı (p<0,001), gece DKB düşmesi (p<0,001), gece Aix@75 (p<0,001), gece periferal direnç (<0,001) göstergeleri arasında istatistiksel olarak anlamlı fark vardı. SONUÇ: Gece kan basıncı yükselen ve %10’dan az düşen hastaların arteriyel sertleşmeye neden olan geleneksel risk faktörlerinin sıkı izleminin ve hipertansiyon tedavilerinde kronoterapinin kullanılmasının yararlı olabileceğini düşünüyoruz.
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  • 3
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  • Turkish

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