Some features of blood pressure variability in patients with arterial hypertension in various modes of antihypertensive therapy

Abstract

Aim. The study objective was to compare different timing modes of hypertension medications dosing in patients with arterial hypertension in relation to blood pressure level and variability.Materials and methods. The study included 103 subjects with previously diagnosed AH in whom 24h ambulatory blood pressure monitoring records of adequate quality were obtained. Participants were stratified to three groups based on timing of hypertension medications dosing – morning dosing (group 1), bedtime dosing (group 2), and as needed (group 3). The last one included patients with low compliance of prescribed medications and irregular antihypertensive drugs intake. The systolic and diastolic blood pressure variability indices – standard deviation (VAR1) and root-mean-square value of the difference between consecutive blood pressure measurements (VAR2) were calculated. The Kruskal-Wallis ANOVA or χ2-test, as appropriate, was used to compare the groups. A two-sided P value <0.05 was considered statistically significant. Analysis of data included corrections for multiple comparisons.Results. Statistically significant differences were found in mean 24-h diastolic blood pressure values between groups 1 and 3, 2 and 3 (P = 0.02), awake mean diastolic blood pressure values between groups 1 and 3 (P = 0.03) and for VAR1 night-time systolic blood pressure between groups 1 and 3, 2 and 3 (P < 0.05). There were no significant differences between any of the studied parameters between the groups with the morning and evening dosing of antihypertensive drugs.Conclusions. Treatment mode does not significantly affect the short-term variability of blood pressure, determined by the standard deviation from the mean blood pressure and the root-mean-square value of the difference between consecutive blood pressure measurements for a given time period.