engleski

Arterial stiffness in hypertensive crisis depending on patient dipping profile

Objective: Arterial stiffness and its value, approximated from pulse wave velocity, correlate with cardiovascular risk. Therapeutic restoration of normal physiologic blood pressure reduction by 10-20% during night-time sleep is the most significant independent predictor of decreased cardiovascular risk. The aim of this study was to present the difference in pulse wave velocity value between gender and their dipping profile. Design and method: We divided 205 patients (54% female) into four groups by their dipping profile and gender. Additionally, because pulse wave velocity depends on age, we created five main age groups (<50, 51-60, 61-70, 71-80, and over 80 years). We checked their dipping profile with 24- hour ambulatory blood pressure monitoring. Pulse wave velocity was checked by an Agedio oscillometer. Also, serum creatinine and glomerular filtration rate were calculated by CKD- EPI formula in all patients. Results: An average glomerular filtrate rate in dipper patients was significantly higher than non-dippers (81.32 vs 72.82 ml/min/1.73m2 ; p<0.05). The number of non- dippers was higher than dippers (103 vs. 39 patients, p<0.01). Women were significantly older than men (69.02 vs. 62.01 years, p<0.01). Comparing pulse wave velocity by age groups and dipping profile in men the results were: 1 – 8.20 vs 8.31m/s ; 2 – 8.78 vs. 9.30m/s ; 3 – 10.01m/s vs. 10.35m/s, p=NS ; 4 – 11.70 vs. 13.27m/s, p<0.01. In women, we found statistically higher values of pulse wave velocity compared to men of the same age groups (11.71 vs. 10.44m/s, p<0.05). By age groups and their dipping profile the results were: 1 – 9.01 vs. 9.04m/s ; 2 – 9.66 vs 9.97m/s, p=NS ; 3 – 10.35 vs. 11.34m/s, p<0.05 ; 4 – 11.85 vs. 12.91m/s, p<0.01). Conclusions: Non- dipping profile could be a potential risk factor for hypertensive crisis development. Pulse wave velocity values increased more rapidly in non- dippers compared to dippers and turned out to be higher in women compared to men of the same age. Treating and discovering non-dipper patients could decrease the level of cardiovascular risk and potentially prevent the incidence of hypertensive crisis events. Kidney function restoration also showed its importance in cardiovascular prevention.

arterial hypertension ; dipping profile ; pulse wave velocity

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