ISSN: 1859 - 2872
Study on 24 hour-blood pressure variability in essential hypertensive patients aged over 60 years, treated at 108 Military Central Hospital
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Objective: Investigation of clinical features, risk factors, 24 hour-blood pressure variability and the relationship between cardiovascular risk factors and 24 hour blood pressure (BP) variability in hypertensive patients over 60 years of age. Subject and method: 83 essential hypertensive patients were treated in A1 Department - 108 Military Central Hospital, from July 2016 to October 2017. Patients were followed 24-hour ambulatory blood pressure monitoring (24-H ABPM) in A11 Department. Prospective, cross-sectional descriptive study. Result: The most common clinical symptom was headache (62.6%), there was 37.3% asymptomatic hypertension. All risk factors were high, the highest risk factors were salty food and dyslipidemia (67.5% and 61.4%). The average value of blood pressure both during the day, night and 24 hours were high. The percentage of hypertension in the daytime 66.3%; nighttime 95.2% and 24 hours 77.1%. The patient with non-dipper 73.5%, morning surge 65.1%, the proportion of the nocturnal dipper was 16.9%. The factors that increased the risk of non-dipper and morning surge were: Age ≥ 70 (OR = 3.69 and 2.67, p<0.05), type 2 diabetes mellitus (OR = 4.32 and 4.46, p<0.05), dyslipidemia (OR = 3.42 and 4.67; p<0.05); Detection time of hypertension > 5 years increased the risk of nocturnal non-dipper (OR = 3.45, p<0.05). Patients with more than 3 cardiovascular risk factors had 4.28 fold risk non-dipper compared to patients with less than 3 risk factors for p<0.05. Conclusion: The average value of blood pressure both during the day, night and 24 hours were increased. Most hypertensive patients have nocturnal non-dipper, over half of them appeared morning surge. The high age ≥ 70, type 2 diabetes mellitus, dyslipidemia increased the risk of nocturnal non-dipper and morning surge. Detection time of hypertension > 5 years increased the risk of nocturnal non-dipper.
Keywords: Essential hypertension, 24-hour ambulatory blood pressure monitoring.
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