Abstract
Introduction and objectives: Coronary heart disease is one of the complications of hypertension. Ambulatory blood pressure monitoring allows studying the different circadian patterns of blood pressure, but there is not enough evidence linking coronary heart disease with different circadian patterns. This research was carried out with the purpose of characterizing the circadian patterns of blood pressure in patients with essential hypertension and coronary heart disease. Methods: Descriptive and transversal research in 68 hypertensive patients with coronary heart disease who underwent ambulatory blood pressure monitoring. The different circadian patterns of blood pressure were related to the different forms of coronary heart disease and to the control of blood pressure. Results: In the sample, women (60.3%) predominated over men (39.7%). The ages were between 45 to 59 (63.3%) and those 60 and over (36.7%). 44.1% did not have their blood pressure under control, 45.6% were overweight and 38.2% were obese. The abnormal patterns were dipper 42.6%, non-dipper 41.2%, extreme dipper 7.4% and riser 8.8%. Morning surge was observed in 29 patients (42.6%), statistically significant in relation to the control of blood pressure (p = 0.033), but not with the different types of coronary heart disease studied. Conclusions: A statistically significant relationship was found between morning surge and control of blood pressure.
Highlights
Introduction and objectivesCoronary heart disease is one of the complications of hypertension
Some studies have shown that the absence of nocturnal decrease in blood pressure (BP) is associated with a worse cardiovascular prognosis and target organ damage (TOD), both in hypertensive patients and in the general population, and it has been shown that the decrease in nighttime SBP is associated with a lower risk of cardiovascular events compared to subjects who do not experience such physiological decline [61,62,63,64]
Multiple pathophysiological abnormalities in essential hypertension could explain the abnormal pattern of BP decrease during sleep associated with coronary heart disease, since it is considered that the non-decrease of nocturnal decrease in BP is a consequence of alterations in the activation of the sympathetic nervous system, stimulation of the renin angiotensin system, insulin resistance and induction of the proliferation of smooth muscle cells in the blood vessels, which can cause alterations in the structure and function of the arteries
Summary
Introduction and objectivesCoronary heart disease is one of the complications of hypertension. This research was carried out with the purpose of characterizing the circadian patterns of blood pressure in patients with essential hypertension and coronary heart disease. Methods: Descriptive and transversal research in 68 hypertensive patients with coronary heart disease who underwent ambulatory blood pressure monitoring. The different circadian patterns of blood pressure were related to the different forms of coronary heart disease and to the control of blood pressure. Morning surge was observed in 29 patients (42.6%), statistically significant in relation to the control of blood pressure (p = 0.033), but not with the different types of coronary heart disease studied. In Cuba, it was estimated that 30.9% of people 15 years of age or older suffer from hypertension according to the III National Survey of risk factors and preventive activities of non-communicable diseases carried out in 2010-2011 [4]. Cardiovascular complications of hypertension are more frequent in the presence of other CRF, so hypertension should be considered as another component of the Cardiovascular Risk (CR) of the subject [8]
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