Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
It is well defined the prognosis value of the abnormalities in the circadian variation in hypertensive patients. In the phisiopathology of heart failure, neurohumoral mechanism plays an important role. Nevertheless, the circadian variation in nonhypertensive heart failure patients has not been well evaluated.
Purpose
Our aim was to evaluate 24-h blood pressure patterns and the prevalence of nocturnal hypertension in patients admitted with acute heart failure.
Methods
We studied 122 patients with a clinical diagnosis of AHF. We permormed a 24-h ambulatory blood pressure monitoring as well as an echocardiogram and anaytical test.
Results
122 patients. Mean age: 63 ± 10. Males: 75%. Mean BMI: 30 ± 6 Kg/m2. Associated risk factors: 56,6% hypertension, 40 % dyslipidemia, 34,7% Diabetes, 29,3% obesity, 22,9% smoking. The etiology of HF: ischemic 41,2%;hypertensive 22,7%; dilated cardiomyopathy 20,9%;valvular 8,3%; others 6,9%.Therapeutic regimen applied: RAS blockers 93,4%; betablockers 85,7%; loop diuretic 81%; spironolactone 42,3%; statins 68,4%; antiplatelet/anticoagulant drugs 89%.
The 24 h ABPM measurements are in table 1
The majority of AHF patients (80,4%) have an abnormal pattern of ABPM: Dipper 19,6%, non-dipper 51,1%, riser 0%.The prevalence of nocturnal hypertension was 22,8%.
Conclusions
In our area, AHF patients have optimal control of BP , however, the normal circadian variation in blood pressure is altered in most of them. In addition, nocturnal hypertension is very common in heart failure patients. Ambulatory blood pressure monitoring may be helpful in identified this altered patterns (which could be unrecognized) and may be used to optimise heart failure therapy, and could be a prognosis marker in this patient group. Table 124 hoursDaytimeNightimeSysolic BP107,7 ± 13,8109,6 ± 14,2104,5 ± 14,5Diastolic BP64,4 ± 7,866,4 ± 8,860,4 ± 7,6
Ambulatory blood pressure monitoring in the primary care setting: Assessment of therapy on circadian variation of blood pressure from the MICCAT-2 trial
