Analysis of nocturnal blood pressure and morning surge in patients attending a specialized center for hypertension in Buenos Aires.

SANCHEZ GELOS DF; OTERO-LOSADA M.; ETCHEGOYEN M.; MIRABELLI L.; GOMEZ-LLAMBI H.; AMBROSIO G.; MILEI J.

Milano

Congreso; 23rd. European Meeting on Hypertension and Cardiovascular Protection; 2013

Eur Society of Hypertension

OBJECTIVE. To evaluate dipping patterns in our study population related to morning surge (MS) values and the influence of hypertension control by treatment.   METHODS. A total of 910 patients were evaluated. The 24-hour Spacelab 90207 ABPM (ambulatory blood pressure monitoring) records of consecutive patients attending the Hypertension Centre of the University of Buenos Aires were retrospectively examined. Exclusion criteria: under 18 years age, <70% successful readings and/or more than 2hr without readings/ 24-hr recording. Cut-off values for hypertension (mmHg): 135/85 day (D), 120/70 night (N). Demographics, sleep schedules and therapeutic schemes documented at the time of monitoring were retrieved. The MS values were calculated as the difference between the average systolic BP (SBP) during 2 hr after waking minus the average SBP during the hour of lowest SBP reading at night. Patients were categorized according with dipping value [Dip= ((SBPday-SBPnight)/SBPday)*100] as: <0% reverse dippers 0%-9.99% non-dippers, 10%-20% dippers, and >20% hyper-dippers. Individuals were grouped according to their treatment and BP as: not treated hypertensive (Hyp), normal BP (Normotensive), treated controlled hypertensive (Hyp controlled) and treated not controlled hypertensive (Hyp not controlled). Statistical analysis: 1) Descriptive: data were summarized and categorized according with central tendency measures and spread estimates, 2) Inferential: data variance analysis (ANOVA) was followed by post-hoc comparisons tests (LSD). A p<0.05 was considered significant (SPSS? 17.0).   RESULTS. Population was integrated by 5.9% reverse-dippers (n= 54), 36.8% non-dippers (n= 335), 49% dippers (n=446) and 8.3% hyper-dippers (n= 75). Table 1 shows nocturnal BP and MS values in relevant dipping groups.   CONCLUSION. 1. In Dipper group: Hypertension induced an increase in MS. Successful treatment reduced MS. 2. In Non-Dipper group: There was no difference regarding MS between Hyp vs. Normotensive or Hyp controlled vs. Hyp not Controlled.