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GENÇ NORMOTANSİF VE HİPERTANSİF BİREYLERDE AYAKTAN KAN BASINCI İZLEMİ SONUÇLARI

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

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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
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