Transient arterial hypotension in hypertensive patients: interrelations with risk factors and target organ damage

Abstract

To investigate the prevalence, clinical manifestation and hemodynamic parameters of short-time arterial hypotension episodes in relation to risk factors and target organ damage in elderly hypertensive patients. Design and methods. 260 hypertensive patients aged 75,0 (68-79) years were investigated. The ambulatory blood pressure monitoring (ABPM) was performed. In the ABPM curves the extreme systolic BP falls were identified, and the hemodynamic parameters and circadian structure of these episodes were analyzed. Antihypertensive treatment regimens, prevalence of risk factors, target organ damage and established cardiovascular diseases were compared in patients with and without BP extreme falls. Results and conclusions. We detected 63 short-time BP falls in 48 (18,5 %) hypertensive patients. Most of them (68,8 %) were asymptomatic. Two time intervals of most frequent BP falls incidence were found, including early morning and postprandial hours. BP falls were associated with the total cholesterol level and left ventricular mass increase, reduced glomerular filtration rate, previous myocardial infarction and angiotensin converting enzyme inhibitors administration. These facts should be taken into account when antihypertensive therapy is administered to elderly subjects.