Aim: The association between a blunted decrease in day-night heart rate and subclinical organ damage has not been investigated earlier in human hypertension. Therefore, we assessed such an association in a cohort of 658 untreated essential hypertensive patients. Methods: All patients underwent procedures including cardiac and carotid ultrasonography, 24-h urine collection for microalbuminuria, ambulatory blood pressure monitoring with simultaneous assessment of heart rate over two 24-h periods within 4 weeks. Nondipping heart rate was defined as a mean heart rate reduction at night lower than 10% compared with daytime values. Results: A reproducible nocturnal dipping (heart rate decrease >10% in both the ambulatory blood pressure monitoring periods) and nondipping profile was found in 513 (78%) and 76 patients (12%), respectively; 69 hypertensive patients (10%) had a variable dipping profile. The three groups did not differ with regard to age, sex, body size, metabolic variables, office and ambulatory blood pressures, left ventricular mass, carotid intima-media thickness, carotid plaque and microalbuminuria. In a univariate analysis, the decrease in nocturnal heart rate did not correlate with any parameter of subclinical organ damage. Conclusion: Our findings from a cross-sectional study do not support the view that a flattened heart rate circadian rhythm is related to a prevalent organ damage in essential hypertension and that this altered pattern is a marker for subclinical cardiovascular disease. The prognostic significance of this finding should be defined by prospective studies. Copyright

Is blunted heart rate decrease at night associated with prevalent organ damage in essential hypertension? / C. Cuspidi, S. Meani, F. Negri, C.Valerio, C. Sala, G. Mancia. - In: BLOOD PRESSURE MONITORING. - ISSN 1359-5237. - 16:1(2011), pp. 16-21.

Is blunted heart rate decrease at night associated with prevalent organ damage in essential hypertension?

C. Sala;
2011

Abstract

Aim: The association between a blunted decrease in day-night heart rate and subclinical organ damage has not been investigated earlier in human hypertension. Therefore, we assessed such an association in a cohort of 658 untreated essential hypertensive patients. Methods: All patients underwent procedures including cardiac and carotid ultrasonography, 24-h urine collection for microalbuminuria, ambulatory blood pressure monitoring with simultaneous assessment of heart rate over two 24-h periods within 4 weeks. Nondipping heart rate was defined as a mean heart rate reduction at night lower than 10% compared with daytime values. Results: A reproducible nocturnal dipping (heart rate decrease >10% in both the ambulatory blood pressure monitoring periods) and nondipping profile was found in 513 (78%) and 76 patients (12%), respectively; 69 hypertensive patients (10%) had a variable dipping profile. The three groups did not differ with regard to age, sex, body size, metabolic variables, office and ambulatory blood pressures, left ventricular mass, carotid intima-media thickness, carotid plaque and microalbuminuria. In a univariate analysis, the decrease in nocturnal heart rate did not correlate with any parameter of subclinical organ damage. Conclusion: Our findings from a cross-sectional study do not support the view that a flattened heart rate circadian rhythm is related to a prevalent organ damage in essential hypertension and that this altered pattern is a marker for subclinical cardiovascular disease. The prognostic significance of this finding should be defined by prospective studies. Copyright
blood pressure monitoring, heart rate, hypertension, organ damage
Settore MED/10 - Malattie dell'Apparato Respiratorio
Settore MED/09 - Medicina Interna
2011
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/167732
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