Peculiarities of indices of 24-hour ambulatory blood pressure monitoring in patients with essential hypertension, complicated with hemorrhagic stroke, after an early recovery period
Journal Title: Український терапевтичний журнал - Year 2019, Vol 0, Issue 1
Abstract
Objective — to determine and evaluate indices of 24-hour ambulatory blood pressure monitoring (24-ABPM) in patients with essential hypertension (EH), complicated with hemorrhagic stroke (HS), after an early recovery period. Materials and methods. The investigation involved 2 groups: the main group included 94 patients (50 women and 44 men, mean age (54.4 ± 8.8) years old), after previous HS as a complication of EH, that took place 6 months or earlier, and who had no spontaneous normalization of blood pressure (BP) over this period. The comparison group consisted of 104 subjects (54 women and 50 men, mean age (53.7 ± 8.9) years old) with EH. The groups matched according to key indices. All investigated subjects underwent 24-ABPM. Results and discussion. The following indices of 24-ABPM in the main group and comparison group (M ± σ) have been established, respectively: mean daytime systolic blood pressure (SBP) was (109.6 ± 15.8) and (121.1 ± 11.3) mm Hg; mean nighttime SBP was (101.9 ± 17.0) and (108.3 ± 14.1) mm Hg; mean 24-hours SBP was (109.6 ± 15.5) and (118.1 ± 9.7) mm Hg. These indices were lower in the main group in contrast to the comparison group (p < 0.05). At the same time, the minimal daytime SBP in the main group ((74.4 ± 19.5) mm Hg), unlike the one of the comparison group ((82.3 ± 12.5) mm Hg), was smaller, and the maximal daytime SBP ((168.2 ± 18.1) mm Hg) was greater in the main group than in the comparison group ((161.9 ± 17.7) mm Hg) (p < 0.05). At the same time, the daytime standard deviation of SBP (17.9 ± 5.9) was bigger in the main group (p < 0.05). The daytime index of hyperbaric impact of SBP was bigger in the main group than in the comparison group — (403.6 ± 250.9) vs. (231.7 ± 123.0), respectively (p < 0.05). By the 24-hour profile of BP in the main group there was a statistically significant smaller percentage of persons, relative to the comparison group, with over-dipper profile (6.4 vs. 20.2 %, respectively) and greater percentage with non-dipper profile (40.4 vs. 26 %, respectively). Conclusions. The results of the study showed the wider ranges of BP fluctuations in patients with hypertension who underwent HS more than 6 months ago, did not have a spontaneous normalization of blood pressure during this period and recovered to 50-100 points on the Barthel scale, when compared to the patients with stage II EH. It was defined based on the significantly higher daytime maximal SBP, ΔSBP and StD. The higher hyperbaric impact index of daytime SBP in the main group reflects the increased load on the cardiovascular system, although mean SBP in these patients is lower than in patients with EH without complications. Based on the 24-hour BP profile, the portion of non-dippers is higher among patients after previous HS. In this group of patients, the exceedance of maximal 24-hour SBP over the mean 24-hour SBP was 54 %, vs 39 % in patients without HS (p < 0.05).
Authors and Affiliations
O. V. Tkachyshyn
Keywords
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- EP ID EP583459
- DOI 10.30978/UTJ2019-1-40
- Views 107
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