Abstract:
:Resistant hypertension (RHTN) includes both patients whose blood pressure (BP) is uncontrolled on three or more medications (uncontrolled RHTN (UCRH)) and patients whose BP is controlled with use of four or more drugs (controlled RHTN (CRH)). It is unknown whether endothelial function and nocturnal drop demonstrate a similar pattern in patients with CRH and UCRH. We examined circadian BP patterns and vascular function in these patients. In all, 40 CRH and 26 UCRH patients, and 25 normotensives underwent biochemical testing, ambulatory BP monitoring, determination of brachial artery responses to endothelial-dependent (flow-mediated; dilation (FMD)) and independent (nitroglycerin mediated) stimuli. The nighttime drop in systolic BP (SBP) and diastolic BP (DBP) was less pronounced in UCRH than in CRH (SBP, 1.9±1.6 versus 4.9±1.7%; DBP, 7.5±1.8 versus 10.9±1.8%, UCRH and CRH, respectively; P<0.05). FMD was greater in control group compared with RHTN patients. Patients with UCRH had significantly impaired FMD compared with CRH (5.9±2.3% versus 7.1±5.1%; P<0.0001). Therefore, UCRH patients have less nocturnal dipping and a more impaired endothelial response compared with CRH patients. These findings suggest that important differences among patients with RHTN may allow identify subgroups with increased cardiovascular risk.
journal_name
J Hum Hypertensjournal_title
Journal of human hypertensionauthors
Quinaglia T,Martins LC,Figueiredo VN,Santos RC,Yugar-Toledo JC,Martin JF,Demacq C,Pimenta E,Calhoun DA,Moreno H Jrdoi
10.1038/jhh.2011.43subject
Has Abstractpub_date
2011-11-01 00:00:00pages
656-64issue
11eissn
0950-9240issn
1476-5527pii
jhh201143journal_volume
25pub_type
杂志文章abstract::Blood pressure (BP) during siesta declines to levels similar to those of night time sleep. The objective of the study was to assess the effect of siesta on 24-h ambulatory BP (ABP) data. Two different approaches were employed for the definition of day and night periods: (1) actual patient reported day and night interv...
journal_title:Journal of human hypertension
pub_type: 杂志文章
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journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章
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journal_title:Journal of human hypertension
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journal_title:Journal of human hypertension
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Journal of human hypertension
pub_type: 杂志文章,meta分析
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pub_type: 杂志文章
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pub_type: 信件
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Journal of human hypertension
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