Hipertansiyon Hastalarında Sistolik Kan Basıncı Değişkenliği ve Kardiyovasküler Riskin Vekil Belirteçleri Arasındaki İlişki

Abstract

Objective: Systolic blood pressure variability (SBPV) is a measure of oscillations in SBP for 24 hours. There are conflicting data about the relationship between SBPV and cardiovascular (CV) diseases. In this study, we aim to document a relationship between SBPV and surrogate markers of CV damage in a hypertensive patient cohort.
 Methods: Previously documented hypertension patients were enrolled. Patients with previously documented CV disease, diabetes mellitus and secondary hypertension were excluded. 24-hour ambulatory blood pressure monitoring (ABPM), echocardiography, electrocardiography and cardio-ankle vascular index (CAVI) measurements were performed. SBPV is defined as the standard deviation of mean systolic blood pressure readings from ABMP records. The relationship between SBPV and QTc distance, QT dispersion, presence of fragmented QRS, CAVI results were examined.
 Results: 64 patients were enrolled mean age 508, 24(37%) were male]. Mean SBPV was 15.124.6 and there was not a significant correlation between SBPV CAVI, QTc measurements of the study patients but there was a significant positive correlation with QT dispersion values (28.615.2, p=0.004, p=0.354). When patients were divided into two categories as high SBPV and low SBPV, QT dispersion was consistently longer in high SBPV group (p=0.006).
 Conclusion: In hypertensive patients without documented CV disease and signs of hypertensive CV changes on clinical evaluation, SBPV is positively correlated with QT dispersion but high SBPV is not related with aortic stiffness according to CAVI results. These findings might be a sign of occult left ventricular fibrosis and high risk of arrhythmia in hypertensive patients with high SBPV.