P808Characteristics of patients with reproducible masked hypertension

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M I Smirnova ◽  
V M Gorbunov ◽  
D A Volkov ◽  
Y N Koshelyaevskaya ◽  
A D Deev ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Aortic Pressure ◽  
Cardiovascular Complications ◽  
Masked Hypertension ◽  
Ambulatory Bp Monitoring ◽  
Oscillometric Device ◽  
The Family ◽  
Ambulatory Patients ◽  
History Of ◽  
Family History Of Hypertension

Abstract Background Masked hypertension (MH) is associated with cardiovascular complications and poor prognosis. Characteristics of untreated patients with reproducible MH are studied insufficiently. Purpose The aim of our study was to assess characteristics of ambulatory patients with reproducible MH in comparison to patients with non-reproducible MH in two visits. Methods The patients from the ambulatory BP monitoring (ABPM) database (>2000 patients) were selected according to the following criteria: absence of any antihypertensive treatment (AHT), availability of clinical BP (CBP) and ABPM records at two visits with the 6 months interval, CBP<140 and 90 mmHg at both visits, availability of clinical, anthropometric data and history. MH criteria in each patients should be present at least at one of the visits. ABPM was performed by the oscillometric device equipped with software for arterial stiffness calculation. The standard statistical methods and analysis of variance (ANOVA) were used. Results We selected 295 patients (men 43%, mean age 49.0±7.6 years, CBP 128.4±9.4/80.5±7.2 mm Hg, body mass index 27.6±4.3 kg/m2, 24h pulse wave velocity in aorta [PWV] 10.7±1.7 m/s). MH only at one visit was found in 168 patients (56.9%). Respectively, MH at both visits was in 127 patients (43.1%). The patients with reproducible MH were characterized by the presence of: mother's (p=0.011) or father's hypertension (p=0.025), mother's ischemic heart disease (p=0.015), mother's myocardial infarction (p=0.020), father's stroke (p=0.030), higher arterial stiffness (PWV 11.0±1.7 m/s vs. 10.5±1.8 m/s, p=0.022), and systolic BP in aorta (120.0±7.5 mmHg vs. 117.8±9.4 mm Hg). Conclusions The patients with reproducible MH (without AHT) are characterized most of all by the family history of hypertension and its complications. The correlation of stable MH with arterial stiffness confirms the importance of PWV and central aortic pressure measurement in patients with CBP<140 and 90 mmHg.

Young patients with type 1 diabetes mellitus are characterised by high frequency of masked hypertension that is associated with increased arterial stiffness

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Troitskaya ◽  
Y Stavtseva ◽  
D Medvedev ◽  
A Petrosyan ◽  
A Safarova ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Arterial Stiffness ◽  
High Frequency ◽  
Young Patients ◽  
Public Institution ◽  
Laboratory Evaluation ◽  
Funding Source ◽  
Masked Hypertension ◽  
History Of

Abstract Background Hypertension (HTN) is a major risk factor for microvascular complications and cardiovascular disease (CVD) in individuals with type 1 diabetes (T1D). Masked and nocturnal HTN are associated with increased cardio-vascular (CV) risk and may be common in patients with T1D. Increased arterial stiffness (AS) is associated with elevated blood pressure (BP) and vascular complications. Very few studies have analyzed the association between masked HTN and markers of AS in T1D. Purpose To evaluate BP phenotypes and their associations with AS and to assess CV risk in young patients with T1D without history of HTN and other known CVD. Methods We included 81 patients with T1D without any history of known CVD. Routine clinical and laboratory evaluation was performed. Office BP was measured with a validated oscillometric device. 24-h ABPM was performed using BPLab Vasotens (“Petr Telegin”). Central BP and AS (carotid-femoral pulse wave velocity (cfPWV)) were measured with applanation tonometry. BP phenotypes were analyzed according to the criteria recommended in ESC/ESH 2018 HTN guidelines. CV risk categories were assessed with the global scale of 10-year risk (ESC 2019). P &lt;0.05 was considered significant. Data are presented as median (interquartile range (IQR)). Results The study group included 39% males, age 27 (23; 34) years, 24.7 smokers, duration of T1D– 6 (2.8; 11) years, HbA1c – 6.9% (5.6; 7.9%). Brachial BP was 122 (110; 122)/80 (70; 80) mmHg; central BP was 109 (100; 118)/72 (67; 78) mmHg, cfPWV – 6.3 (5.3; 6.7) m/s. High and very high 10-year CV risk was observed in 87.7% of patients. True HTN was observed in 5 (6.2%) patients, masked – in 31 (38.3%), white-coat – in 1 (1.2%), true normotension in 44 (54.3%). Isolated nocturnal HTN was found in 30.7% of patients with office BP &lt;140/90 mmHg. 41% of all patients with clinical normotension had masked HTN and isolated nocturnal HTN was present in 74.2% of them. The most common patterns of diurnal index were non-dipping (63,9%) and night-peaking (16.6%). Patients with masked HTN compared to patients with true normotension were older (31±8.6 vs 26.4±5.5 years, p=0.02), had longer duration of T1D (6 (3; 12.9) vs 4 (0.7; 8) years, p=0.009), higher urine albumin/creatinine ratio (18.5 (11; 29) vs 8 (3; 17) mg/g, p&lt;0.001) and higher cfPWV (7.2 (6.2; 8.2) vs 6.3 (5.8; 6.8) m/s, p=0.002). Conclusions Young patients with T1D and clinical normotension are characterized by high frequency of masked HTN (41%) especially isolated nocturnal HTN (74.2%), and high rate of non-dipping. Masked HTN is associated with higher cfPWV and higher albuminuria. This may reflect early vascular changes and potentially lead to further CV risk elevation in this population. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): The publication was prepared with the support of the “RUDN University Program 5-100”

Increased Erythrocyte Lithium-Sodium Countertransport in Essential Hypertension: Its Relationship to Family History of Hypertension

1981 ◽  
Vol 61 (s7) ◽  
pp. 13s-15s ◽  
Author(s):  
M. Canali ◽  
L. Borghi ◽  
E. Sani ◽  
A. Curti ◽  
A. Montanari ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Family History ◽  
High Blood Pressure ◽  
Degree Relative ◽  
Mean Values ◽  
The Family ◽  
History Of ◽  
Family History Of Hypertension ◽  
And Control

1. Erythrocyte lithium—sodium counter-transport was measured in 46 normotensive healthy controls without family history of hypertension, 15 subjects with essential hypertension, but without evidence of family history of high blood pressure, and 43 subjects with essential hypertension and at least one hypertensive first-degree relative. 2. Mean values (mmol h−1 l−1 of erythrocytes) were 0.248 ± 0.092 in controls, 0.258 ± 0.087 in hypertensive subjects without family history (not significant vs controls), 0.360 ± 0.115 in hypertensive subjects with family history of hypertension (P &lt; 0.001 vs controls), 0.334 ± 0.117 in all hypertensive subjects, both with and without family history (P &lt; 0.001 vs controls). 3. Our data confirm the finding of an increased erythrocyte lithium-sodium counter-transport, but with a significant overlap between essential hypertension and control values. Lithium-sodium countertransport is higher only in hypertensive subjects with at least one hypertensive first-degree relative. 4. We suggest that the increase of lithium-sodium countertransport in erythrocytes is not a consistent marker of essential hypertension. It seems to be associated with the family prevalence and/or the hereditability of hypertension, rather than with high blood pressure per se.

scholarly journals CIRCADIAN BLOOD PRESSURE PROFILE IN YOUNG SUBJECTS WITH PRE-HYPERTENSION

2013 ◽  
Vol 19 (3) ◽  
pp. 263-269 ◽  
Author(s):  
M. E. Evsevyeva ◽  
E. A. Mishchenko ◽  
M. V. Rostovtseva ◽  
I. Y. Galkova ◽  
E. V. Chudnovsky ◽  
...  
Keyword(s):  
Pressure Profile ◽  
Effective Prevention ◽  
Ambulatory Bp Monitoring ◽  
Blood Pressure Profile ◽  
The Family ◽  
History Of ◽  
Young Subjects ◽  
Working Day ◽  
Design And Methods ◽  
Circadian Blood Pressure Profile

and arterial hypertension for the planning of timely and effective prevention. Design and methods.We enrolled 147 people: with optimal and normal BP — 81, with high normal BP — 30 men, and 36 controls. Ambulatory BP monitoring (ABPM) nas performed in the offi ce at the setting of ≪typical working day≫ or 24 +- 1,5 hours with 15 and 30 minute intervals between the measurements during the day and night, respectively.Results.Young people with high normal BP differ from the subjects with normal and optimal BP by a variety of ABPM indices. However, the changes are lower, but similar to those observed in patients with evident hypertension, including increase of mean systolic and diastolic BP, time index of systolic and diastolic BP, and morning BP surge. Young men with high normal BP are also characterized by the family history of the early cardiovascular disease and the presence of cardiocerebral complaints with the frequency similar to that in hypertensive subjects.Conclusions.Young subjects with high normal BP seem to be at higher risk, and should undergo early and effective preventive measures.

scholarly journals P1189OFFICE AND AMBULATORY RECORDING OF CENTRAL AORTIC PRESSURES, WAVE REFLECTION AND ARTERIAL STIFFNESS INDICES IN PERITONEAL DIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Vasilios Vaios ◽  
Panagiotis Georgianos ◽  
Georgia Vareta ◽  
Evaggelia Geropoulou ◽  
Evangelia Ntounousi ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Arterial Stiffness ◽  
Augmentation Index ◽  
Prognostic Significance ◽  
Hemodynamic Variables ◽  
Oscillometric Device ◽  
Cardiovascular Morbidity And Mortality ◽  
Ambulatory Recording ◽  
History Of ◽  
Aortic Blood Pressure

Abstract Background and Aims Among peritoneal dialysis (PD) patients, aortic blood pressure (BP) and arterial stiffness indices are independent predictors of cardiovascular morbidity and mortality. Previous studies in PD patients recorded these parameters only in the office. The present study provides comparisons between office and ambulatory recordings of these parameters and explores the association of demographic, clinical and hemodynamic variables with high arterial stiffness. Method In 81 stable PD patients (mean age: 61.3±16.3 years; male gender: 64.2%), brachial and aortic BP, heart rate-adjusted augmentation index (AIx75) and pulse wave velocity (PWV) were recorded after a 5-minute seated rest in the office using the oscillometric device Mobil-O-Graph (IEM, Stolberg, Germany). Subsequently, all patients underwent ambulatory recording of these parameters with the same device for 24 hours. Logistic regression analysis was performed to identify factors independently associated with high ambulatory PWV. Results As expected, office brachial systolic BP (SBP) was higher than 24-hour brachial SBP (134.2±22.7 vs. 129.0±18.0 mmHg, P&lt;0.01). Similarly, office aortic SBP was higher than 24-hour aortic SBP (122.5±20.1 vs. 117.1±16.1 mmHg, P=0.001). By contrast, office AIx75 did not differ from 24-hour AIx75 (23.4%±11.7% vs. 23.9%±9.3%, P=0.602), whereas office PWV was only slightly higher than 24-hour PWV (9.2±2.3 vs. 9.0±2.2m/sec, P=0.001). Participants stratified in the high PWV tertile were older, had higher 24-hour mean BP (MBP) and had more commonly history of diabetes, dyslipidemia and coronary heart disease. In multivariate analysis, older age (OR: 4.23; 95% CI: 1.59-11.24) and higher 24-hour MBP (OR: 1.31; 95% CI: 1.03-1.67) were the only independent determinants of high PWV. Conclusion Among patients on PD, brachial and central aortic pressures recorded in the office were higher than 24-hour ambulatory pressures, whereas this variation between office and ambulatory recordings was diminished for AIx75 and PWV. Future studies are warranted to explore the prognostic significance of these parameters in the PD population.

Arterial stiffness is increased in healthy subjects with a positive family history of hypertension

2015 ◽  
Vol 37 (8) ◽  
pp. 622-626 ◽  
Author(s):  
Jinbo Liu ◽  
Hongyu Wang ◽  
Hongwei Zhao ◽  
Huan Liu ◽  
Lihong Li ◽  
...  
Keyword(s):  
Family History ◽  
Arterial Stiffness ◽  
Healthy Subjects ◽  
Positive Family History ◽  
History Of ◽  
Family History Of Hypertension

scholarly journals Ambulatory Blood Pressure Monitoring to Diagnose and Manage Hypertension

Hypertension ◽  
2021 ◽  
Vol 77 (2) ◽  
pp. 254-264
Author(s):  
Qi-Fang Huang ◽  
Wen-Yi Yang ◽  
Kei Asayama ◽  
Zhen-Yu Zhang ◽  
Lutgarde Thijs ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Randomized Clinical Trials ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Cardiovascular Complications ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Clinical Implementation ◽  
Ambulatory Bp Monitoring

This review portrays how ambulatory blood pressure (BP) monitoring was established and recommended as the method of choice for the assessment of BP and for the rational use of antihypertensive drugs. To establish much-needed diagnostic ambulatory BP thresholds, initial statistical approaches evolved into longitudinal studies of patients and populations, which demonstrated that cardiovascular complications are more closely associated with 24-hour and nighttime BP than with office BP. Studies cross-classifying individuals based on ambulatory and office BP thresholds identified white-coat hypertension, an elevated office BP in the presence of ambulatory normotension as a low-risk condition, whereas its counterpart, masked hypertension, carries a hazard almost as high as ambulatory combined with office hypertension. What clinically matters most is the level of the 24-hour and the nighttime BP, while other BP indexes derived from 24-hour ambulatory BP recordings, on top of the 24-hour and nighttime BP level, add little to risk stratification or hypertension management. Ambulatory BP monitoring is cost-effective. Ambulatory and home BP monitoring are complimentary approaches. Their interchangeability provides great versatility in the clinical implementation of out-of-office BP measurement. We are still waiting for evidence from randomized clinical trials to prove that out-of-office BP monitoring is superior to office BP in adjusting antihypertensive drug treatment and in the prevention of cardiovascular complications. A starting research line, the development of a standardized validation protocol for wearable BP monitoring devices, might facilitate the clinical applicability of ambulatory BP monitoring.

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