scholarly journals Ambulatory blood pressure monitoring in patients with ST- elevation myocardial infarction: one year follow-up study

2019 ◽  
Vol 7 (11) ◽  
pp. 4054
Author(s):  
Srikanth Nathani
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
St Elevation ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: The aim of this study was evaluation of nocturnal dipping of blood pressure in ST-elevation myocardial infarction (STEMI) patients and determining the effect of dipping on outcomes at 12 months follow-up.Methods: This was an observational, single-centre, retrospective study that included STEMI patients, performed in a tertiary care hospital in India from November 2016 to October 2017. The primary endpoint of the study was the assessment of outcomes at 12 months.  The patients were divided into two groups on the basis of blood pressure dipping, i.e., patients with positive dipping were considered in group 1 and patients with negative dipping were considered in group 2.Results: Total 43 patients were included in the study. Group 1 consisted of 27 patients and Group 2 consisted of 16 patients. Mean 24 hr systolic blood pressure (SBP) and asleep SBP in Group 1 patients was 128.15±18.05 mmHg and 122.67±18.94 mmHg, respectively. Mean 24 hr diastolic (DBP) and asleep DBP in Group 1 patients was 78.07±10.73 mmHg and 73.41±12.35 mmHg, respectively. In the patients with non-dipping, mean 24 hr SBP and asleep SBP was 130.56±27.32 mmHg and 135.13±29.58 mmHg, respectively. Mean 24 hr DBP and asleep DBP was 76.00±15.40 mmHg and 79.69±17.05 mmHg, respectively. The mean percentage of asleep dipping of SBP was 5.7±6.7% in Group 1 and -4.6±6.82% in Group 2. Similarly, the mean percentage of asleep dipping of DBP was 7.6±9.0% in Group 1 and -6.3±9.1% in Group 2.Conclusions: In view of the results, it can be concluded that ambulatory blood pressure monitoring in patients with STEMI can provide a significant prognostication of the future events.

scholarly journals P0150EFFECT OF SEROTONIN REUPTAKE INHIBITORS (SSRIS) AND SEROTONIN-NOREPINEPHRINE REUPTAKE INHIBITORS (SNRIS) ON BLOOD PRESSURE VARIABILITY USING 24 HOURS AMBULATORY BLOOD PRESSURE MONITORING

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nabeel Aslam ◽  
Sobia Memon ◽  
Hani Wadei ◽  
Shehzad Niazi
Keyword(s):  
Blood Pressure ◽  
Linear Regression ◽  
Ambulatory Blood Pressure ◽  
Psychiatric Diagnosis ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Night Time ◽  
Group 2 ◽  
Adverse Cardiovascular Outcome ◽  
Group 1

Abstract Background and Aims Hypertension (HTN) and psychiatric disorders frequently co-exist in general population. Serotonin re-uptake inhibitors (SSRIs) and serotonin-norepinephrine re-uptake inhibitors (SNRIs) affect serotonin and norepinephrine and may lead to variation in blood pressure (BP). There is paucity of data on blood pressure variations using 24 hours ambulatory blood pressure monitoring (ABPM) with the use of SSRIs/NSRIs. Method Subjects who underwent psychiatric evaluation and ABPM within six month of each other between 1/1/2012 to 12/31/2016 at Mayo Clinic Florida were identified using billing data. Demographics, co-morbidities, medications, ABPM, and laboratory results were retrospectively collected from medical records. Subjects were divided into groups – subjects with no psychiatric diagnosis and no psychiatric medicine (Group 1) and subjects with psychiatric diagnosis and on SSRIs/NSRIs (Group 2). BP systolic and diastolic levels (day time, night time) were compared between groups controlling for age, sex, race, presence or absence of HTN, diabetes mellitus (DM) and smoking. Single and multivariable linear regression models were used to analyze group differences. Results Total of 367 subjects met inclusion criteria – Group 1=135; Group 2=232. The subjects in group 2 were older (median age 57 yrs vs 47 yrs p<0.001), white (69.8 vs 60% p=0.002), smokers (15.9 vs 3.0% p<0.001), history of HTN (62.5 vs 9.6%), and DM (21.1% vs 0%). ABPM showed that subjects in group 2 had higher median daytime systolic BP (131 vs 124), higher median night time systolic BP (120 vs 110), and higher median night time diastolic BP (68 vs 63). Multivariable linear regression controlling for age, sex, race, presence or absence of HTN, DM, and smoking showed that use of SSRIs/NSRIs (group 2) was significantly associated with higher night time systolic BP (8.36 mm; 95% CI 4.2, 12.5; p <0.0001) and higher night time diastolic BP (4.6 mm, 95% CI 1.9, 7.29, p=0.001). On subgroup analysis comparing subjects with use of SSRIs vs NSRIs, there was no statistically significant difference in the daytime or night time systolic or diastolic BP. Conclusion Use of SSRIs and NSRIs are associated with higher nocturnal systolic and diastolic BP, which can potentially increase the risk of adverse cardiovascular outcome in this population. Higher nocturnal BP may be due to ongoing sympathetic activation during sleep with serotonin and norepinephrine with the use of SRRIs and NSRI. Further well designed prospective studies using ABPM are needed to determine the risk of nocturnal hypertension with the use of SSRIs/NSRIs that could have potential adverse cardiovascular outcome.

Regression to the mean of repeated ambulatory blood pressure monitoring in five studies

2019 ◽  
Vol 37 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Myles N. Moore ◽  
Emily R. Atkins ◽  
Abdul Salam ◽  
Michele L. Callisaya ◽  
James L. Hare ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Regression To The Mean ◽  
Pressure Monitoring ◽  
The Mean

Ambulatory Blood Pressure Monitoring in Multiple Myeloma Patients Treated with VAD Protocol.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5124-5124
Author(s):  
Angelika Pyszel ◽  
Monika Biedron ◽  
Rafal Poreba ◽  
Tomasz Wrobel ◽  
Grzegorz Mazur ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Multiple Myeloma ◽  
Diastolic Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Hypertensive Patients ◽  
The Mean ◽  
The Impact

Abstract BACKGROUND: Corticosteroids are still a cornerstone in multiple myeloma (MM) therapy, both as a single agent and as a part of many protocols, including VAD regimen (vincristine, adriblastine, dexamethasone). Corticosteroids are known to be involved in blood pressure (BP) regulation and to affect this parameter. The impact of dexamethasone (Dex) administration on BP in MM patients during VAD protocol treatment is poorly documented. AIM: The purpose of the study was to evaluate the blood pressure changes during Dex administration in patients treated with VAD protocol due to MM. METHODS: Thirteen patients with MM (7 men and 6 women; mean age 62,45 ± 8,14) were assessed. Primary hypertensive patients (7 persons) were not excluded. They were administered Dex in standard dose of 40 mg (day 1–4, 9–12, 17–21) according to VAD protocol. Blood pressure was assessed by the use of commercially available instruments of Ambulatory Blood Pressure Monitoring (ABPM). The BP recordings lasted 48 hours, were started on the day before the first day of VAD and were obtained every 10 minutes during mornings, every 15 minutes during the rest of days and every 20 minutes during nights. Average of systolic and diastolic blood pressure (SBP/DBP) were estimated for the 2-hour time before Dex and for the 14-hour time in the 2-hour periods after Dex. Minimal and maximal range of SBP/DBP increase and the mean amount of SBP/DBP increase were also determined. RESULTS: 48-hour BP recordings revealed a significant increase in systolic and diastolic blood pressure after Dex administration in all patients. SBP and DBP began to increase after 3 hours after Dex, then rose continually and reached the peak in the period from 6 to 10 hour after Dex. In comparison to 2-hour period before Dex, in which SBP/DBP amounted 139,63/82,92 ± 23,47/9,38 mmHg, the mean SBP/DBP increase rate was: in the 2–4 hour period after Dex - 146,68/88,15 ± 24,38/10,51 mmHg (p<0,05), in the 6–8 – 148,07/92,66 ± 14,07/9,04 mmHg (ns), in the 8–10 – 147,8/87,99 ± 14,07/9,04 mmHg (p<0,01), in the 10–12 – 143,44/86,12 ± 17,22/9,77 mmHg (p<0,05) and in the 12–14 – 144,47/88,59 ± 17,04/12,54 mmHg (p<0,01). The minimal range of SBP/DBP increase was 10,50/−2,00 mmHg, maximal range of SBP/DBP increase was 35,43/40,00 mmHg and the mean amount of SBP/DBP increase was 20,06/11,6 ± 8,36/14,23 mmHg. CONCLUSION: Our preliminary study revealed that Dex administration causes an increase in BP in all patients. The mean increase in BP amounted 20,06/11,6 ± 8,36/14,23 mmHg and was similar in all patients, regardless their initial value of BP. So our study demonstrates the need of individualized hypertension treatment with strict control of BP in hypertensive patients when corticosteroid therapy is indicated.

scholarly journals Efficacy of chlorthalidone and hydrochlorothiazide in combination with amiloride in multiple doses on blood pressure in patients with primary hypertension: a protocol for a factorial randomized controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Vítor Magnus Martins ◽  
Lucas Helal ◽  
Filipe Ferrari ◽  
Leonardo Grabinski Bottino ◽  
Sandra Costa Fuchs ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Primary Hypertension ◽  
Blood Pressure Lowering ◽  
Pressure Monitoring ◽  
Pressure Lowering ◽  
The Mean

Abstract Background Thiazide diuretics have demonstrated favorable blood pressure lowering efficacy, but the equivalent doses of their more common agents, chlorthalidone and hydrochlorothiazide, are still unclear. Further, concerns exist regarding adverse metabolic effects, which may be attenuated with the concomitant administration of a potassium-sparing diuretic, such as amiloride. This trial aims to investigate the efficacy of chlorthalidone and hydrochlorothiazide, in combination with amiloride at different doses, for initial management of patients with primary hypertension. Methods/design This is a factorial (2 × 2) randomized double-blinded clinical trial comparing the association of a thiazide diuretic (chlorthalidone 25 mg/day or hydrochlorothiazide 50 mg/day) with a potassium-sparing diuretic (amiloride 10 mg/day or amiloride 20 mg/day) in patients with primary hypertension. The primary outcome will be the mean change from baseline in 24-h systolic and diastolic blood pressure measured by ambulatory blood pressure monitoring. The secondary outcomes will be the mean change from baseline in daytime and nighttime systolic and diastolic blood pressure measured by ambulatory blood pressure monitoring, mean change from baseline in systolic and diastolic blood pressure measured by office blood pressure, incidence of adverse events, variation of laboratory parameters, and proportion of patients who achieved blood pressure control. The follow-up will last 12 weeks. For a P alpha of 0.05, power of 80%, standard deviation of 9 mmHg, and absolute difference of 6 mmHg on systolic blood pressure on 24-h ambulatory blood pressure monitoring, it will be necessary to study a total of 76 patients. The sample size will be increased by 10% to compensate for losses, resulting in 84 patients being randomized. Discussion Diuretics are pivotal drugs for the treatment of hypertension. Chlorthalidone and hydrochlorothiazide, in combination with amiloride in multiple doses, will be tested in terms of blood pressure lowering efficacy and safety. Since the intensity of blood pressure reduction is the major determinant of reduction in cardiovascular risk in hypertensive patients, this study will help to determine which combination of diuretics represents the most appropriate treatment for this population. Trial registration ClinicalTrials.gov, NCT03928145. Registered on 25 April 2019. Last update on 29 April 2019.

Ambulatory Blood Pressure Monitoring After Acute Myocardial Infarction

2003 ◽  
Vol 10 (2) ◽  
pp. 75-80 ◽  
Author(s):  
Lanfranco Antonini ◽  
Furio Colivicchi ◽  
Salvatore Greco ◽  
Vincenzo Guido ◽  
Solferina Malfatti ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Acute Myocardial Infarction ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring

scholarly journals Ambulatory blood pressure monitoring in young adults with different levels of office blood pressure

2018 ◽  
Vol 24 (4) ◽  
pp. 427-434
Author(s):  
N. T. Vatutin ◽  
E. V. Sklyannaya
Keyword(s):  
Blood Pressure ◽  
Young People ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Office Blood Pressure ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Pressure Monitoring ◽  
Group 2

Objectiveof our study was to assess the ambulatory blood pressure monitoring (ABPM) in young people with different office blood pressure (BP).Design and methods. We included 981 students of a medical university at the age of 20–29 years (536 men, 445 women). ABPM was performed using the device “Kardiotekhnika 4000” (Inkart, Russia), the data were processed using the program “KT Result2” (Inkart, Russia).Results. The optimal BP during office measurement was recorded in 220 patients (22,4 %, group 1), normal — in 488 (49,8 %, group 2), high normal — in 134 (13,6 %, group 3), hypertension (HTN) 139 (14,2 %, group 4). The proportion of males was significantly higher in groups 3 and 4 (96,6 % and 85,6 %) compared with groups 1 and 2 (47,7 % and 40,2 %, respectively, p < 0,001). The median systolic BP (SBP) was 123 (110; 126) mm Hg, diastolic BP (DBP) — 85 (84; 87) mm Hg. According to the ABPM, the parameters of SBP and DBP correlated with the corresponding office BP parameters. A strong direct correlation was found for both SBP (rs= 0,87) and DBP (rs= 0,85). Daytime variability of SBP was significantly higher in individuals with high normal BP and HTN (15,9 ± 2,6 and 17,2 ± 4,2 mm Hg) compared to groups 1 and 2 (9,2 ± 4,4 and 9,9 ± 3,0, respectively, p < 0,05). The majority of young people had normal BP decrease at night (dipper), non-dipper profile was also frequent. Over-dipper and night-peaker profiles were rarely recorded. In the groups 3 and 4, a larger number of non-dipper patients were observed compared with groups 1 and 2 (23,9 % and 34,6 %, compared with 10,0 % and 11,1 %, respectively, p < 0,001). The prevalence of white-coat hypertension (WCH) among the young people was 0,31 % (95 % CI 0,06–0,75 %), among subjects with office HTN 2,2 % (95 % CI 0,4–5,3 %). The prevalence of masked hypertension (MHTN) in the studied population was 1,4 % (95 % CI 0,8–2,3 %), among normotensive subjects — 1,7 % (95 % CI 0,9–2,6 %), among subjects with high normal BP — 10,4 % (95 % CI 5,8–16,2 %).Conclusions. ABPM in young hypertensive patients is characterized by higher variability of daytime SBP. The majority (56,1 %)of HTN subjects had normal BP decrease at night. The prevalence of WCH among young people is 0,31 % (95 % CI 0,06–0,75 %). The prevalence of MHTN among young people is 1,4 % (95 % CI 0,8–2,3 %).

scholarly journals Efficacy of chlorthalidone and hydrochlorothiazide in combination with amiloride in multiple doses on blood pressure in patients with primary hypertension: a protocol for a factorial randomized controlled trial.

2019 ◽  
Author(s):  
Vitor Magnus Martins ◽  
Lucas Helal ◽  
Filipe Ferrari ◽  
Leonardo Grabinski Bottino ◽  
Sandra Costa Fuchs ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Primary Hypertension ◽  
Blood Pressure Lowering ◽  
Pressure Monitoring ◽  
Pressure Lowering ◽  
The Mean

Abstract Background Thiazide diuretics have demonstrated favorable blood pressure lowering efficacy, but it is still unclear what are the equivalence of doses of their more common agents, chlorthalidone and hydrochlorothiazide. Further, there exist concerns regarding adverse metabolic effects which may be attenuated with the concomitant administration of a potassium-sparing diuretic, such as amiloride. This trial aims to investigate the efficacy of chlorthalidone and hydrochlorothiazide, in combination with amiloride in different doses, for the initial management in patients with primary hypertension. Methods This is a factorial (2x2) randomized double-blinded clinical trial comparing the association of a thiazide diuretic (chlorthalidone 25 mg/day or hydrochlorothiazide 50 mg/day) with a potassium-sparing diuretic (amiloride 10 mg/day or amiloride 20 mg/day) in patients with primary hypertension. The primary outcome will be the mean change from baseline in 24-h systolic and diastolic blood pressure measured by ambulatory blood pressure monitoring. The secondary outcomes will be the mean change from baseline in daytime and nighttime systolic and diastolic blood pressure measured by ambulatory blood pressure monitoring, mean change from baseline in systolic and diastolic blood pressure measured by office blood pressure, incidence of adverse events, variation of laboratory parameters and proportion of patients who achieved blood pressure control. The follow-up will last 12 weeks. For a P alpha of 0.05, power of 80%, and standard deviation of 9 mmHg, and absolute difference of 6 mmHg on systolic blood pressure on 24-h ambulatory blood pressure monitoring, it will be necessary to study a total of 76 patients. The sample size will be increased by 10% to compensate losses, resulting in 84 patients being randomized. Discussion Diuretics are pivotal drugs for the treatment of hypertension. Chlorthalidone and hydrochlorothiazide, in combination with amiloride in multiple doses, will be tested in terms of blood pressure lowering efficacy and safety. Since the intensity of blood pressure reduction is the major determinant of reduction in cardiovascular risk in hypertensive patients, this study will help to determine which combination of diuretics represents the most appropriate treatment for this population.

scholarly journals Efficacy of chlorthalidone and hydrochlorothiazide in combination with amiloride in multiple doses on blood pressure in patients with primary hypertension: a protocol for a factorial randomized controlled trial.

2019 ◽  
Author(s):  
Vitor Magnus Martins ◽  
Lucas Helal ◽  
Filipe Ferrari ◽  
Leonardo Grabinski Bottino ◽  
Sandra Costa Fuchs ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Primary Hypertension ◽  
Blood Pressure Lowering ◽  
Pressure Monitoring ◽  
Pressure Lowering ◽  
The Mean

Abstract Background Thiazide diuretics have demonstrated favorable blood pressure lowering efficacy, but it is still unclear what are the equivalence of doses of their more common agents, chlorthalidone and hydrochlorothiazide. Besides, concernments about adverse metabolic effects do exist, which may be attenuated with the concomitant administration of a potassium-sparing diuretic, such as amiloride. This trial aims to investigate the efficacy of chlorthalidone and hydrochlorothiazide, in combination with amiloride in different doses, for the initial management in patients with primary hypertension. Methods This is a factorial (2x2) randomized double-blinded clinical trial comparing the association of a thiazide diuretic (chlorthalidone 25 mg/day or hydrochlorothiazide 50 mg/day) with a potassium-sparing diuretic (amiloride 10 mg/day or amiloride 20 mg/day) in patients with primary hypertension. The primary outcome will be the mean change from baseline in 24-h systolic and diastolic blood pressure measured by ambulatory blood pressure monitoring. The secondary outcomes will be the mean change from baseline in daytime and nighttime systolic and diastolic blood pressure measured by ambulatory blood pressure monitoring, mean change from baseline in systolic and diastolic blood pressure measured by office blood pressure, incidence of adverse events, variation of laboratory parameters and proportion of patients who achieved blood pressure control. The follow-up will last 12 weeks. For a P alpha of 0.05, power of 80%, and standard deviation of 9 mmHg, and absolute difference of 6 mmHg on systolic blood pressure on 24-h ambulatory blood pressure monitoring, it will be necessary to study a total of 76 patients. The sample size will be increased by 10% to compensate losses, resulting in 84 patients being randomized. Discussion Diuretics are pivotal drugs for the treatment of hypertension. Chlorthalidone and hydrochlorothiazide, in combination with amiloride in multiple doses, will be tested in terms of blood pressure lowering efficacy and safety. Since the intensity of blood pressure reduction is the major determinant of reduction in cardiovascular risk in hypertensive patients, this study will help to determine which combination of diuretics represents the most appropriate treatment for this population.

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