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Birmingham WC, Herr RM, Cressman M, Patel N, Hung M. While You Are Sleeping: Marital Ambivalence and Blunted Nocturnal Blood Pressure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:723. [PMID: 38928969 PMCID: PMC11204195 DOI: 10.3390/ijerph21060723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/29/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
Marital relationships offer health benefits, including a lower risk of cardiovascular disease (CVD). However, quality of the relationship matters; ambivalent behaviors may increase CVD risk by affecting blunted nocturnal blood pressure (BP) dipping. This study tracked daytime and nocturnal SBP and DBP in 180 normotensive individuals (90 couples; participant mean age 25.04; 91.58% white) over a 24 h period using ambulatory blood pressure monitors to explore the impact of martial quality. Results showed that perceptions of spousal ambivalence were associated with blunted nocturnal BP dipping. Perceptions of one's own behavior as ambivalent also showed blunted nocturnal dipping. When in an ambivalent relationship, a gender interaction was found such that women were most likely to have blunted SBP dipping, but men were more likely to have blunted nocturnal DBP dipping. Overall, this study found an association between ambivalence and BP dipping, thus uncovering one virtually unexplored pathway by which marital relationships may have adverse effects on health.
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Affiliation(s)
| | - Raphael M. Herr
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Mikel Cressman
- Psychology Department, Brigham Young University, Provo, UT 84602, USA;
| | - Neha Patel
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA (M.H.)
| | - Man Hung
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA (M.H.)
- Department of Orthopedic Surgery Operations, University of Utah, Salt Lake City, UT 84108, USA
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2
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Cömerter D, Baysal T, Doğan S, Erdem A, Çınar T. Comparison of choroidal thickness and choroidal vascular index in normotensive dippers and nondippers. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20230950. [PMID: 38511753 PMCID: PMC10941874 DOI: 10.1590/1806-9282.20230950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 03/22/2024]
Abstract
OBJECTIVE The aim of this study was to evaluate the choroidal thickness and choroidal vascular index in normotensive individuals with dipping and nondipping patterns. METHODS Patients who applied to the cardiology clinic for routine checkups and underwent 24-h blood pressure monitoring were included in our study. They were divided into two groups based on their dipper status. The patients in whom systolic blood pressure decreased during the nocturnal time by 10% or more of the daily blood pressure were defined as dippers. On the contrary, patients whose nocturnal systolic blood pressure decreased by less than 10% were defined as nondippers. Choroidal thickness and choroidal vascular index were measured by spectral-domain optical coherence tomography. Central macular thickness, retinal nerve fiber layer, and ganglion cell layer (GCL) analyses were also recorded. RESULTS In total, 35 patients with dipper pattern and 34 patients with nondipper pattern were recruited. The mean subfoveal choroidal thickness was 349.72±90 μm in the dipper group and 358.54±132.5 μm in the nondipper group. The groups had no significant difference in choroidal thickness, central macular thickness, retinal nerve fiber layer, and ganglion cell layer analyses. However, the choroidal vascular index was statistically significantly lower in the nondipper group when compared to the dipper group (0.61±0.02 vs. 0.64±0.02; p<0.001). Also, the choroidal vascular index was negatively correlated with subfoveal choroidal thickness in the nondipper group (Spearman; r=-0.419; p=0.033). CONCLUSION Our study showed that the choroidal vascular index was significantly lower in nondippers than in dippers. Nondipper individuals may be affected by vascular dysregulation, leading to alterations in the choroidal circulation.
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Affiliation(s)
- Doğukan Cömerter
- University of Health Sciences, Sultan Abdülhamid Han Training and Research Hospital, Department of Ophthalmology – Istanbul, Turkey
| | - Taha Baysal
- University of Health Sciences, Sultan Abdülhamid Han Training and Research Hospital, Department of Ophthalmology – Istanbul, Turkey
| | - Selami Doğan
- University of Health Sciences, Sultan Abdülhamid Han Training and Research Hospital, Department of Cardiology – Istanbul, Turkey
| | - Almina Erdem
- University of Health Sciences, Sultan Abdülhamid Han Training and Research Hospital, Department of Cardiology – Istanbul, Turkey
| | - Tufan Çınar
- University of Health Sciences, Sultan Abdülhamid Han Training and Research Hospital, Department of Cardiology – Istanbul, Turkey
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3
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Nakagawa N, Sato N. Potential impact of non-dipping pulse rate pattern and nocturnal high pulse rate variability on target organ damage in patients with cardiovascular risk. Hypertens Res 2023; 46:1054-1055. [PMID: 36697875 DOI: 10.1038/s41440-023-01186-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 12/29/2022] [Indexed: 01/26/2023]
Affiliation(s)
- Naoki Nakagawa
- Division of Cardiology, Nephrology, Pulmonology, and Neurology, Department of Internal Medicine, Asahikawa, Japan.
| | - Nobuyuki Sato
- Division of Cardiology, Nephrology, Pulmonology, and Neurology, Department of Internal Medicine, Asahikawa, Japan.,Educational center, Asahikawa Medical University, Asahikawa, Japan
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Long-term reduction in morning and nighttime blood pressure after renal denervation: 36-month results from SPYRAL HTN-ON MED trial. Hypertens Res 2023; 46:280-288. [PMID: 36241705 PMCID: PMC9747613 DOI: 10.1038/s41440-022-01042-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 02/03/2023]
Abstract
Elevated morning and nighttime blood pressures (BP) are associated with increased risk of cardiovascular events such as stroke and myocardial infarction. We compared the long-term changes in morning and nighttime BP in patients with uncontrolled hypertension (office systolic BP between 150 and <180 mmHg/diastolic BP ≥ 90 mmHg; mean ambulatory systolic BP (SBP) between 140 and <170 mmHg; 1-3 prescribed antihypertensive medications). Eighty patients were randomized to RDN or sham control. In patients taking at least 3 antihypertensive medications at 36 months (N = 23 RDN group; N = 23 sham group), the 24 h ambulatory SBP as well as morning (7:00-9:00AM) and nighttime (1:00-6:00AM) ambulatory SBP were significantly lower for the RDN group compared to sham control (24 h SBP: -20.2 vs. -10.2, p = 0.0087; morning SBP: -23.9 vs. -8.0 mmHg, p = 0.029; nighttime SBP: -20.8 vs. -7.2 mmHg, p = 0.0011). At 36 months, 24 h SBP was controlled to <130 mmHg in 40% of RDN patients in the morning compared to 6% for the sham group; P = 0.021 and in 80% of the RDN patients at night compared to 39% in the sham group; P = 0.019. Major adverse events through 36 months were rare in both groups, and there were no renal artery re-interventions or vascular complications. Morning and nighttime SBP were significantly lower in patients prescribed at least 3 antihypertensive medications at 36 months in the SPYRAL HTN-ON MED trial for RDN compared with sham control. The results suggest RDN has significant benefit when the risk of cardiovascular events is highest.
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5
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Mogi M. Hypertension management to prevent dementia. Hypertens Res 2022; 45:573-575. [DOI: 10.1038/s41440-022-00869-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 01/24/2022] [Indexed: 11/09/2022]
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6
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Relation between nocturnal decline in blood pressure and choroidal thickness: a comparative analysis in dipper vs. non-dipper hypertensive patients. Blood Press Monit 2021; 26:176-182. [PMID: 33252363 DOI: 10.1097/mbp.0000000000000502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare choroidal thickness (ChT) and echocardiographical changes in patients with dipper and non-dipper systemic arterial hypertension (HT). METHODS Patients with HT were evaluated in two groups according to the 24-hour ambulatory BP monitoring. Compared to day-time values, those whose night-time SBP decreased ≥10% were defined as dippers, and those whose SBP decreased <10% were defined as non-dippers. Transthoracic echocardiography was conducted in all patients. ChT and central macular thickness were measured with spectral-domain optical coherence tomography. ChT was obtained at the subfoveal, 1500 µm nasal and temporal to the fovea. RESULTS Thirty non-dipper (18 females and 12 males) and 23 dipper (16 females and seven males) hypertensive patients were recruited. Sex distribution and the mean age were similar between the groups (P = 0.472; P = 0.12). Disease duration was longer in the non-dipper group (8 ± 3.39 vs. 4.96 ± 1.19 years, P = 0.001). The non-dipper group had lower ChT in subfoveal and temporal locations (P = 0.02 and 0.03, respectively) and higher left atrial volume index (LAVI) and pulmonary valve maximum flow (PV-max; P < 0.001). The night-time SBP was negatively correlated with ChT (P = 0.048) and positive correlated with LAVI and PV-max (P < 0.05). However those correlations were not significant when were controlled by the possible confounding factors as disease duration, age and gender. CONCLUSION Non-dipper HT patients may have thinner choroid than dippers due to longer duration of HT and higher ambulatory BP levels.
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Zhang P, Jin MY, Song XY, Wang Z, Jiang YH, Yang CH. Comparison of the antihypertensive efficacy of morning and bedtime dosing on reducing morning blood pressure surge: A protocol for systemic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24127. [PMID: 33592863 PMCID: PMC7870267 DOI: 10.1097/md.0000000000024127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/09/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND It is well known that morning blood pressure surge increases the risk of myocardial events in the first several hours post-awakening. This meta-analysis was performed to compare the antihypertensive efficacy of morning and bedtime dosing on decreasing morning blood pressure surge. METHODS Articles in 4 databases about clinical trials of ingestion time of antihypertensive drugs were searched and performed a meta-analysis to evaluate the different effects on morning blood pressure and absolute blood pressure (BP) reduction from baseline of between bedtime administration (experimental group) and morning awaking administration (control group). RESULTS The aim of this study is to compare the antihypertensive efficacy of morning and bedtime dosing on decreasing morning blood pressure surge. CONCLUSIONS The bedtime will provide evidence support for clinicians and patients for reducing morning blood pressure surge. ETHICS AND DISSEMINATION This study does not require ethical approval.
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Affiliation(s)
- Peng Zhang
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250355
| | - Mei-Ying Jin
- Yanzhou District Hospital of Traditional Chinese Medicine, Jining 272100
| | - Xu-Yu Song
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250355
| | - Zhao Wang
- Shandong College of Traditional Chinese Medicine
| | - Yue-Hua Jiang
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, China
| | - Chuan-Hua Yang
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, China
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8
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Tomitani N, Hoshide S, Kario K. Self-measured worksite blood pressure and its association with organ damage in working adults: Japan Morning Surge Home Blood Pressure (J-HOP) worksite study. J Clin Hypertens (Greenwich) 2021; 23:53-60. [PMID: 33283972 PMCID: PMC8029969 DOI: 10.1111/jch.14122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 02/01/2023]
Abstract
The effects of elevations in blood pressure (BP) on worksite stress as an out-of-office BP setting have been evaluated using ambulatory BP monitoring but not by self-measurement. Herein, we determined the profile of self-measured worksite BP in working adults and its association with organ damage in comparison with office BP and home BP measured by the same home BP monitoring device. A total of 103 prefectural government employees (age 45.3 ± 9.0 years, 77.7% male) self-measured their worksite BP at four timepoints (before starting work, before and after a lunch break, and before leaving the workplace) and home BP in the morning, evening, and nighttime (at 2, 3, and 4 a.m.) each day for 14 consecutive days. In the total group, the average worksite systolic BP (SBP) was significantly higher than the morning home SBP (129.1 ± 14.3 vs. 124.4 ± 16.4 mmHg, p = .026). No significant difference was observed among the four worksite SBP values. Although the average worksite BP was higher than the morning home BP in the study participants with office BP < 140/90 mmHg (SBP: 121.4 ± 9.4 vs. 115.1 ± 10.4 mmHg, p < .001, DBP: 76.0 ± 7.7 vs. 72.4 ± 8.4 mmHg, p = .013), this association was not observed in those with office BP ≥ 140/90 mmHg or those using antihypertensive medication. Worksite SBP was significantly correlated with the left ventricular mass index evaluated by echocardiography (r = 0.516, p < .0001). The self-measurement of worksite BP would be useful to unveil the risk of hypertension in working adults who show normal office and home BP.
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Affiliation(s)
- Naoko Tomitani
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
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9
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Chawla O, Kumar B, Bhattacharjee M, Singh A. Circadian rhythm of blood pressure: Implications for antihypertensive management. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2021. [DOI: 10.4103/injms.injms_4_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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10
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Gong S, Xu Y, Ye R, Liu K, Li J, Yang C, Yan X, Chen X. Peak blood pressure-guided monitoring may serve as an effective approach for blood pressure control in the out-of-office setting. J Clin Hypertens (Greenwich) 2020; 22:2192-2201. [PMID: 33058413 DOI: 10.1111/jch.14080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/01/2020] [Accepted: 09/11/2020] [Indexed: 02/05/2023]
Abstract
We aimed to explore whether diurnal blood pressure (BP) peak characteristics have a significant influence on the association between left ventricular damage with the two BP components (morning BP vs. afternoon peak BP) in untreated hypertensives. This cross-sectional study included 1084 hypertensives who underwent echocardiography and 24-h ambulatory BP monitoring. Participants were stratified according to the relationship between morning systolic BP (MSBP; average SBP within 2 h of waking up) and afternoon peak systolic BP (ASBP; average SBP between 16:00 and 18:00). Afternoon and morning hypertension was defined as ≥ 135/85 mm Hg. The morning and afternoon peak BPs occurred at around 7:00 and 17:00, respectively. In general hypertensives, morning BP and afternoon peak BP are significantly different in absolute values (for binary SBP, McNemar's χ2 = 6.42; p = .014). ASBP was more pronounced than MSBP in 602 patients (55.5%), in whom 24-h SBP showed higher consistency with ASBP than with MSBP (Kappa value: 0.767 vs 0.646, both p < .01). In subjects with ASBP ≥ MSBP, ASBP was associated with left ventricular hypertrophy independent of MSBP (logistic regression analysis odds ratio: 1.046, p < .01), and left ventricular mass index was more strongly correlated with ASBP than with MSBP (multiple regression coefficient β: 0.453, p < .01), in which the relationships held true independently of 24-h SBP. The opposite results were obtained in subjects with MSBP > ASBP. Peak BP-guided monitoring may serve as an effective approach to out-of-office hypertension monitoring and control, providing the best consistency with 24-h average SBP and highest discrimination performance for target organ damage, independently of 24-h SBP.
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Affiliation(s)
- Shenzhen Gong
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Ying Xu
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Runyu Ye
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Kai Liu
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiangbo Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Changqiang Yang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Yan
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoping Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
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11
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Chung WB, Ihm SH, Jang SW, Her SH, Park CS, Lee JM, Chang K, Jeon DS, Yoo KD, Seung KB. Effect of Fimasartan versus Valsartan and Olmesartan on Office and Ambulatory Blood Pressure in Korean Patients with Mild-to-Moderate Essential Hypertension: A Randomized, Double-Blind, Active Control, Three-Parallel Group, Forced Titration, Multicenter, Phase IV Study (Fimasartan Achieving Systolic Blood Pressure Target (FAST) Study). DRUG DESIGN DEVELOPMENT AND THERAPY 2020; 14:347-360. [PMID: 32158190 PMCID: PMC6986172 DOI: 10.2147/dddt.s231293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/30/2019] [Indexed: 11/30/2022]
Abstract
Purpose Head-to-head comparison of the blood pressure (BP) lowering effect of fimasartan versus valsartan, with olmesartan as a reference, on office blood pressure and ambulatory BP. Patients and Methods Of the 369 randomly assigned patients in this study, 365 hypertensive patients were referred as the full analysis set and divided into 3 groups with a 3:3:1 ratio (fimasartan group: 155, valsartan group: 157, olmesartan group: 53). After the 2-week single-blind placebo run-in period, initial standard doses of 60-mg fimasartan, 80-mg valsartan, and 10-mg olmesartan were administered for 2 weeks, then forcibly up-titrated higher doses (fimasartan 120 mg, valsartan 160 mg, olmesartan 20 mg) were given for 4 weeks. ABP was measured before and after the 6-week treatment. Primary endpoint was reduction of sitting office systolic BP (SiSBP) of fimasartan compared to valsartan after 6 weeks. Secondary endpoints were reduction of sitting office diastolic BP (SiDBP) and 24 hrs, day-time, and night-time mean systolic and diastolic ABP (ASBP, ADBP) after 6 weeks. Results Patients’ mean age was 58.34±7.68 years, and 289 patients were male (79.18%). After the 6-week treatment, SiSBP reduction of fimasartan and valsartan were −16.26±15.07 and −12.81±13.87 (p=0.0298) and SiDBP were −7.63±9.67 and −5.14±8.52 (p=0.0211). Reductions in 24 hrs mean ASBP were −15.22±13.33 and −9.45±12.37 (p=0.0009), and ADBPs were −8.74±7.55 and −5.98±7.85 (p=0.0140). Reductions of night-time ASBPs were −16.80±15.81 and −10.32±14.88 (p=0.0012), and those of night-time ADBPs were −8.89±9.93 and −5.55±9.70 (p=0.0152). Reduction of BP in olmesartan group did not demonstrate significant difference with fimasartan group in all end-points. Conclusion Fimasartan 120-mg treatment demonstrated superior efficacy in reduction of SiSBP, SiDBP, and 24 hrs ASBP and ADBP compared to valsartan 160 mg. Reduction of night-time ASBP from baseline was largest in fimasartan group, suggesting that fimasartan may be effective for recovering dipping pattern. NCT number NCT02495324 (Fimasartan Achieving SBP Target (FAST) study).
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Affiliation(s)
- Woo-Baek Chung
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang-Hyun Ihm
- Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Won Jang
- Division of Cardiology, Department of Internal Medicine, St. Paul's Hospital
| | - Sung-Ho Her
- Daejeon St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chul Soo Park
- Division of Cardiology, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Min Lee
- Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kiyuk Chang
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Doo-Soo Jeon
- Division of Cardiology, Department of Internal Medicine, In-Cheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki-Dong Yoo
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki-Bae Seung
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
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Palatini P, Verdecchia P, Beilin LJ, Eguchi K, Imai Y, Kario K, Ohkubo T, Pierdomenico SD, Saladini F, Schwartz JE, Wing L, Signorotti S, Reboldi G. Association of Extreme Nocturnal Dipping With Cardiovascular Events Strongly Depends on Age. Hypertension 2020; 75:324-330. [DOI: 10.1161/hypertensionaha.119.14085] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Whether extreme dipping is associated with cardiovascular events (CVE) is unclear. The present study was conducted to test the hypothesis that the prognostic role of extreme dipping varies as a function of age. The analysis was performed in 10 868 participants (53% men) aged 53±15 (mean±SD) years enrolled in 8 prospective studies. Using the ambulatory systolic blood pressure nocturnal decline, we identified 4 groups: dippers (>10%–20%), nondippers (>0%–10%), reverse dippers (≤0%), and extreme dippers (>20%). The association between dipping category and CVE was estimated as a function of age using Cox models adjusted for sex, average 24-hour systolic blood pressure, and traditional risk factors. During a median follow-up of 5.7 years, there were a total of 829 CVE (168 fatal). For extreme dippers, no increase in risk of CVE was observed among the participants <70 years (hazard ratio, 0.99 [95% CI, 0.73–1.34];
P
=0.93) compared with dippers. In contrast, among the participants ≥70 years, there was a significant increase in risk (hazard ratio, 1.88 [95% CI, 1.14–3.11];
P
=0.013). Among the octogenarians, the hazard ratio (95% CI) for CVE were 2.34 (1.12–4.93) for nondippers (
P
=0.024), 3.91 (1.75–8.73) for reverse dippers (
P
=0.001), and 4.12 (1.64–10.37) for extreme dippers (
P
=0.003) compared with dippers. These data show that extreme dipping is not associated with poorer outcome in people younger than 70 years. A U-shaped relationship between nocturnal blood pressure dipping and adverse outcome is present in subjects older than 70 years. In the octogenarian extreme dippers, the risk of CVEs was 4× higher than in the dippers and similar to that in the reverse dippers.
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Affiliation(s)
- Paolo Palatini
- From the University of Padova, Padua, Italy (P.P., F.S.)
| | | | | | - Kazuo Eguchi
- Saitama Red Cross Hospital, Tochigi, Japan (K.E., K.K.)
| | - Yutaka Imai
- Tohoku Institute for Monitoring of Blood Pressure, Sendai, Japan (Y.I., T.O.)
| | - Kazuomi Kario
- Saitama Red Cross Hospital, Tochigi, Japan (K.E., K.K.)
| | - Takayoshi Ohkubo
- Tohoku Institute for Monitoring of Blood Pressure, Sendai, Japan (Y.I., T.O.)
- Teikyo University School of Medicine, Tokyo, Japan (T.O.)
| | | | | | - Joseph E. Schwartz
- Columbia University, New York, NY (J.E.S.)
- Stony Brook University, New York, NY (J.E.S.)
| | - Lindon Wing
- Flinders University, Adelaide, Australia (L.W.)
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13
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Di Gennaro F, D'Amato C, Morganti R, Greco C, Longo S, Corradini D, Lauro D, Spallone V. Morning blood pressure surge is associated with autonomic neuropathy and peripheral vascular disease in patients with diabetes. J Hum Hypertens 2019; 34:495-504. [PMID: 31624311 DOI: 10.1038/s41371-019-0270-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/24/2019] [Accepted: 09/27/2019] [Indexed: 11/09/2022]
Abstract
Although vascular and autonomic nervous system have been involved in the regulation of morning surge in blood pressure (MBPS), data on clinical correlates of MBPS in diabetic population are scarce, in particular with regard to diabetic complications. This study was aimed at investigating predictors and correlates of MBPS in diabetes. In a cross-sectional study including 167 patients with diabetes (age 58.5 ± 11.1 years, duration 15.9 ± 12.1 years), clinical variables, diabetic and neuropathic complications, and MBPS (using 24-h ambulatory blood pressure monitoring) were measured. The upper quartile of MBPS (>30.5 mmHg) was associated with higher values of waist circumference (P = 0.027), triglycerides (P = 0.021), and Michigan Diabetic Neuropathy Score (P = 0.042), with lower HDL cholesterol (P = 0.030), and with the presence of cardiovascular autonomic neuropathy (CAN) (P = 0.016) and peripheral vascular disease (PVD) (P < 0.0001). In a logistic regression analysis, PVD (odds ratio: 10.2, P = 0.001), CAN (odds ratio: 6.09, P = 0.016), and diastolic blood pressure (BP) (odds ratio: 1.06, P = 0.022) predicted MBPS upper quartile (r2 = 0.20, P = 0.0005). In a multiple regression analysis, PVD (P = 0.002) and diastolic BP (P = 0.003) were the only determinants of MBPS (r2 = 0.20). MBPS upper quartile was associated with BP dipping (systolic BP day-night reduction > 10%) (P = 0.012), and MBPS was positively related to systolic (rho = 0.41, P < 0.0001) and diastolic BP day-night reduction. In conclusion, metabolic syndrome stigmata, diastolic BP, CAN and PVD are the main predictors of MBPS in the diabetic population. Excessive MBPS and nondipping are not concurrent 24-h BP alterations. Autonomic dysfunction might exert an exacerbating effect on MBPS phenomenon.
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Affiliation(s)
- Federica Di Gennaro
- Endocrinology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Cinzia D'Amato
- Endocrinology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Roberto Morganti
- Endocrinology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Carla Greco
- Endocrinology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Susanna Longo
- Endocrinology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Diana Corradini
- Endocrinology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Davide Lauro
- Endocrinology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Vincenza Spallone
- Endocrinology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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14
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Gong S, Liu K, Ye R, Li J, Yang C, Chen X. Nocturnal dipping status and the association of morning blood pressure surge with subclinical target organ damage in untreated hypertensives. J Clin Hypertens (Greenwich) 2019; 21:1286-1294. [PMID: 31376230 DOI: 10.1111/jch.13641] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/20/2019] [Accepted: 05/28/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Shenzhen Gong
- Department of Cardiology, West China Hospital Sichuan University Chengdu China
| | - Kai Liu
- Department of Cardiology, West China Hospital Sichuan University Chengdu China
| | - Runyu Ye
- Department of Cardiology, West China Hospital Sichuan University Chengdu China
| | - Jiangbo Li
- Department of Cardiology, West China Hospital Sichuan University Chengdu China
| | - Changqiang Yang
- Department of Cardiology, West China Hospital Sichuan University Chengdu China
| | - Xiaoping Chen
- Department of Cardiology, West China Hospital Sichuan University Chengdu China
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15
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Abstract
BACKGROUND The morning period which is recognized as the highest risk for cardiovascular events is associated with a surge in blood pressure (BP). However, it is unclear what aspect of this rise is important. AIM To determine whether the rate of rise (RoR), the magnitude (day night difference) or the product [BP power (BPPower)] is associated with increased cardiovascular risk. METHODS We developed a logistic equation method to fit individual 24-h patterns of BP to determine RoR, amplitude and BPPower using the ambulatory recordings from the Ohasama study including 564 men and 971 women (16.6 years follow-up). RESULTS Men had a higher risk of cardiovascular events than women (24, 16%, P < 0.001). Age and night BP were strong linear risk predictors. In men sorting risk by quintiles of BPPower (adjusted for age, night BP, smoking status) revealed no clear linear or nonlinear pattern. However, in women BPPower had a U-shaped relationship with the lowest risk being the 2-3rd quintile for all cardiovascular events (Pquadratic = 0.01) including cardiovascular death (Pquadratic = 0.03) and nonfatal stroke (Pquadratic = 0.02). A similar but less clear trend was observed with the RoR but only stroke (infarct) reached significance (Pquadratic = 0.03) while sorting by range showed a U shaped pattern for combined cardiovascular events (Pquadratic = 0.04). CONCLUSION These findings suggest that the morning BPPower is an important independent risk factor for predicting cardiovascular events and stroke but only in women with median levels having the lowest risk.
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16
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Morning Surge and Peak Morning Ambulatory Blood Pressure Versus Automated Office Blood Pressure in Predicting Cardiovascular Disease. High Blood Press Cardiovasc Prev 2019; 26:209-215. [PMID: 30989620 DOI: 10.1007/s40292-019-00315-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/09/2019] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Automated office blood pressure (AOBP) has been recently shown to predict equally well to ambulatory blood pressure (ABP), conventional office blood pressure (OBP) and home blood pressure (HBP), cardiovascular (CV) events among hypertensives. AIM To compare AOBP recording and ABP monitoring in order to evaluate morning blood pressure (BP) peak in predicting CV events and deaths in hypertensives. METHODS We assessed 236 initially untreated hypertensives, examined between 2009 and 2013. The end points were CV and non-CV death and any CV event including myocardial infarction, evidence of coronary heart disease, heart failure hospitalization, severe arrhythmia, stroke, and symptomatic peripheral artery disease. We fitted proportional hazards models using the different modalities as predictors and evaluated their predictive performance using two metrics: the Akaike's Information Criterion, and Harrell's C-index. RESULTS After a mean follow-up of 7 years, 23 subjects (39% women) had at least one CV event. In Cox regression models, systolic conventional OBP, AOBP and peak morning BP were predictive of CV events (p < 0.05). The Akaike Information Criterion showed smaller values for AOBP than peak morning BP, indicating a better performance in predicting CV events (227.2736 and 238.7413, respectively). The C-index was 0.6563 for systolic AOBP and 0.6243 for peak morning BP indicating a better predicting ability for AOBP. CONCLUSION In initially untreated hypertensives, AOBP appears to be at least equally reliable to 24-h monitoring in the evaluation of morning BP peak in order to detect CV disease whereas the sleep-trough and preawakening morning BP surge did not indicate such an effect.
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17
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Impact of the 2017 American College of Cardiology/American Heart Association Blood Pressure Guidelines on the Next Blood Pressure Guidelines in Asia. Curr Hypertens Rep 2019; 21:2. [PMID: 30631970 DOI: 10.1007/s11906-019-0906-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE OF REVIEW To estimate the impact of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines for high blood pressure (BP) on the next hypertension guidelines in Asia. RECENT FINDINGS The 2017 ACC/AHA guidelines for high BP in adults changed the diagnostic threshold and the management goal of BP from 140/90 to 130/80 mmHg. Another characteristic of the new guideline is its focus on a practical approach for the effective management of hypertension by using home and ambulatory BP monitoring; this point is also recommended in the 2014 Japanese Society of Hypertension Guidelines for the Management of Hypertension. In Japan, the guidelines for hypertension management are currently under revision and will be released in the spring of 2019. The core concept of the 2019 Japanese Society of Hypertension Guidelines for the Management of Hypertension, i.e., early and tight BP control over 24 h, will contribute to target-organ protection and cardiovascular disease prevention for Asians.
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18
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Morning Blood Pressure Surge Relates to Autonomic Neural Activity in Young Non-Dipping Adults: The African-PREDICT Study. Heart Lung Circ 2018; 28:1197-1205. [PMID: 30093314 DOI: 10.1016/j.hlc.2018.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 05/24/2018] [Accepted: 07/04/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND It is well established that an exaggerated morning blood pressure surge (MBPS) is associated with an increased risk for cardiovascular disease development in hypertensive individuals. However, in non-dipping individuals, a lower surge was reportedly associated with increased cardiovascular risk. Sympathetic nervous system activity is involved in 24-hour blood pressure fluctuations, including night-time dipping and the MBPS. To better understand this interaction, we investigated associations of MBPS with heart-rate variability and baroreceptor sensitivity in young healthy dippers and non-dippers. METHODS We included black and white men and women (n=827), aged 20-30 years and determined the MBPS using two formulas: the sleep-trough and dynamic morning surge. For autonomic function we determined baroreceptor sensitivity and heart-rate variability. RESULTS The majority of non-dippers in this population were black (70.4%), presenting lower sleep-trough and dynamic morning surge (all p<0.001). Heart-rate variability was comparable between dippers and non-dippers, whereas baroreceptor sensitivity was higher in non-dippers (p=0.021). Despite a suppressed MBPS profile in non-dippers, we found both sleep-trough (β=-0.25; p=0.039) and dynamic morning surge (β=-0.14; p=0.047) to be inversely and independently associated with 24-hour heart-rate variability (total power). These results were absent in dippers. CONCLUSIONS In conclusion, we found a higher night-time blood pressure coupled with lower MBPS in young healthy non-dippers. Furthermore, this lower MBPS was independently and negatively associated with autonomic neural activity, suggesting increased autonomic function involvement in MBPS suppression of non-dippers. The predictive value of suppressed nocturnal dipping pattern should be investigated while taking autonomic neural activity into account.
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19
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Morning blood pressure surge in young black and white adults: The African-PREDICT Study. J Hum Hypertens 2018; 33:22-33. [DOI: 10.1038/s41371-018-0089-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 11/09/2022]
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20
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Fujiwara T, Hoshide S, Kanegae H, Nishizawa M, Kario K. Reliability of morning, before-dinner, and at-bedtime home blood pressure measurements in patients with hypertension. J Clin Hypertens (Greenwich) 2018; 20:315-323. [DOI: 10.1111/jch.13165] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/28/2017] [Accepted: 09/30/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Takeshi Fujiwara
- Division of Cardiovascular Medicine; Department of Medicine; Jichi Medical University School of Medicine; Shimotsuke Japan
- Higashiagatsuma-machi National Health Insurance Clinic; Gunma Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine; Department of Medicine; Jichi Medical University School of Medicine; Shimotsuke Japan
| | - Hiroshi Kanegae
- Division of Cardiovascular Medicine; Department of Medicine; Jichi Medical University School of Medicine; Shimotsuke Japan
- Genkiplaza Medical Center for Health Care; Tokyo Japan
| | - Masafumi Nishizawa
- Division of Cardiovascular Medicine; Department of Medicine; Jichi Medical University School of Medicine; Shimotsuke Japan
- Minamisanriku Hospital; Miyagi Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine; Department of Medicine; Jichi Medical University School of Medicine; Shimotsuke Japan
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21
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Kario K, Tomitani N, Buranakitjaroen P, Chen C, Chia Y, Divinagracia R, Park S, Shin J, Siddique S, Sison J, Soenarta AA, Sogunuru GP, Tay JC, Turana Y, Wang J, Wong L, Zhang Y, Wanthong S, Hoshide S, Kanegae H. Rationale and design for the Asia BP@Home study on home blood pressure control status in 12 Asian countries and regions. J Clin Hypertens (Greenwich) 2018; 20:33-38. [PMID: 29265725 PMCID: PMC8030943 DOI: 10.1111/jch.13145] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/11/2017] [Accepted: 09/22/2017] [Indexed: 01/04/2023]
Abstract
Home blood pressure (BP) monitoring is endorsed in multiple guidelines as a valuable adjunct to office BP measurements for the diagnosis and management of hypertension. In many countries throughout Asia, physicians are yet to appreciate the significant contribution of BP variability to cardiovascular events. Furthermore, data from Japanese cohort studies have shown that there is a strong association between morning BP surge and cardiovascular events, suggesting that Asians in general may benefit from more effective control of morning BP. We designed the Asia BP@Home study to investigate the distribution of hypertension subtypes, including white-coat hypertension, masked morning hypertension, and well-controlled and uncontrolled hypertension. The study will also investigate the determinants of home BP control status evaluated by the same validated home BP monitoring device and the same standardized method of home BP measurement among 1600 or more medicated patients with hypertension from 12 countries/regions across Asia.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Naoko Tomitani
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Peera Buranakitjaroen
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Chen‐Huan Chen
- Department of MedicineFaculty of MedicineNational Yang‐Ming UniversityTaipeiTaiwan
| | - Yook‐Chin Chia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
- Sunway Institute for Healthcare DevelopmentSunway UniversitySelangor Darul EhsanMalaysia
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center IncQuezon CityPhilippines
| | - Sungha Park
- Division of CardiologyCardiovascular HospitalYonsei Health SystemSeoulKorea
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | | | - Jorge Sison
- Department of MedicineMedical Center ManilaErmita, ManilaPhilippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular MedicineUniversity of Indonesia‐National Cardiovascular CenterHarapan Kita, JakartaIndonesia
| | - Guru Prasad Sogunuru
- Apollo HospitalsChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingaporeSingapore
| | - Yuda Turana
- Department of NeurologyFaculty of MedicineAtma Jaya Catholic University of IndonesiaNorth Jakarta, JakartaIndonesia
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsThe Shanghai Institute of HypertensionShanghai Key Laboratory of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Lawrence Wong
- Department of Medicine and TherapeuticsDivision of Neurology, Chinese University of Hong KongHong Kong
| | - Yuqing Zhang
- Divisions of Hypertension and Heart FailureFu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Sirisawat Wanthong
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Hiroshi Kanegae
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
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22
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Olesen TB, Stidsen JV, Blicher MK, Pareek M, Rasmussen S, Vishram-Nielsen JK, Olsen MH. Impact of Age and Target-Organ Damage on Prognostic Value of 24-Hour Ambulatory Blood Pressure. Hypertension 2017; 70:1034-1041. [DOI: 10.1161/hypertensionaha.117.09173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 02/19/2017] [Accepted: 08/16/2017] [Indexed: 12/25/2022]
Abstract
Markers of target-organ damage and 24-hour ambulatory blood pressure (BP) measurement improve cardiovascular risk stratification. The prevalence of target-organ damage and raised BP increases with aging. The study aim was to evaluate the impact of age and target-organ damage on the prognostic value of ambulatory BP. Markers of target-organ damage and ambulatory BP were measured in 1408 healthy people aged 41 or 51 (middle-aged group), and 61 or 71 (older group) years. The primary outcome was cardiovascular events after 16 years of follow-up, with data obtained from national registries. The prognostic value of BP was evaluated with Cox regression models, adjusted for traditional risk factors and target-organ damage, including left ventricular mass, pulse wave velocity, carotid plaques, and urine albumin/creatinine ratio. A total of 323 events were observed. In comparison with traditional risk factors, adding systolic BP and presence of target-organ damage improved risk stratification by increasing concordance index from 0.711 to 0.728 (
P
=0.01). In middle-aged subjects with target-organ damage, increment in pulse pressure (hazard ratio, 1.70; 95% confidence interval, 1.31–2.21;
P
<0.01) and increment in average real variability (hazard ratio, 1.29; 95% confidence interval, 1.05–1.59;
P
=0.02) were associated with a greater risk of cardiovascular disease compared with subjects without target-organ damage: hazard ratio, 1.04 (95% confidence interval, 0.74–1.46;
P
=0.81);
P
for interaction, 0.02; and hazard ratio, 0.89 (95% confidence interval, 0.69–1.14;
P
=0.36);
P
for interaction, 0.01. Target-organ damage may be a marker of individual susceptibility to the harmful effects of pulse pressure and BP variability on the cardiovascular system in middle-aged individuals.
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Affiliation(s)
- Thomas B. Olesen
- From the Department of Endocrinology, Odense University Hospital, Denmark (T.B.O., J.V.S., M.K.B., M.P.); Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Denmark (S.R.); Research Centre for Prevention and Health, Glostrup Hospital, University of Copenhagen, Denmark (J.K.K.V.-N.); Department of Internal Medicine, Holbæk Hospital, Denmark (M.P., M.H.O.); and Centre for Individualized Medicine in Arterial Diseases, Odense University Hospital, Denmark
| | - Jacob V. Stidsen
- From the Department of Endocrinology, Odense University Hospital, Denmark (T.B.O., J.V.S., M.K.B., M.P.); Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Denmark (S.R.); Research Centre for Prevention and Health, Glostrup Hospital, University of Copenhagen, Denmark (J.K.K.V.-N.); Department of Internal Medicine, Holbæk Hospital, Denmark (M.P., M.H.O.); and Centre for Individualized Medicine in Arterial Diseases, Odense University Hospital, Denmark
| | - Marie K. Blicher
- From the Department of Endocrinology, Odense University Hospital, Denmark (T.B.O., J.V.S., M.K.B., M.P.); Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Denmark (S.R.); Research Centre for Prevention and Health, Glostrup Hospital, University of Copenhagen, Denmark (J.K.K.V.-N.); Department of Internal Medicine, Holbæk Hospital, Denmark (M.P., M.H.O.); and Centre for Individualized Medicine in Arterial Diseases, Odense University Hospital, Denmark
| | - Manan Pareek
- From the Department of Endocrinology, Odense University Hospital, Denmark (T.B.O., J.V.S., M.K.B., M.P.); Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Denmark (S.R.); Research Centre for Prevention and Health, Glostrup Hospital, University of Copenhagen, Denmark (J.K.K.V.-N.); Department of Internal Medicine, Holbæk Hospital, Denmark (M.P., M.H.O.); and Centre for Individualized Medicine in Arterial Diseases, Odense University Hospital, Denmark
| | - Susanne Rasmussen
- From the Department of Endocrinology, Odense University Hospital, Denmark (T.B.O., J.V.S., M.K.B., M.P.); Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Denmark (S.R.); Research Centre for Prevention and Health, Glostrup Hospital, University of Copenhagen, Denmark (J.K.K.V.-N.); Department of Internal Medicine, Holbæk Hospital, Denmark (M.P., M.H.O.); and Centre for Individualized Medicine in Arterial Diseases, Odense University Hospital, Denmark
| | - Julie K.K. Vishram-Nielsen
- From the Department of Endocrinology, Odense University Hospital, Denmark (T.B.O., J.V.S., M.K.B., M.P.); Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Denmark (S.R.); Research Centre for Prevention and Health, Glostrup Hospital, University of Copenhagen, Denmark (J.K.K.V.-N.); Department of Internal Medicine, Holbæk Hospital, Denmark (M.P., M.H.O.); and Centre for Individualized Medicine in Arterial Diseases, Odense University Hospital, Denmark
| | - Michael H. Olsen
- From the Department of Endocrinology, Odense University Hospital, Denmark (T.B.O., J.V.S., M.K.B., M.P.); Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Denmark (S.R.); Research Centre for Prevention and Health, Glostrup Hospital, University of Copenhagen, Denmark (J.K.K.V.-N.); Department of Internal Medicine, Holbæk Hospital, Denmark (M.P., M.H.O.); and Centre for Individualized Medicine in Arterial Diseases, Odense University Hospital, Denmark
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23
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Development of a New ICT-Based Multisensor Blood Pressure Monitoring System for Use in Hemodynamic Biomarker-Initiated Anticipation Medicine for Cardiovascular Disease: The National IMPACT Program Project. Prog Cardiovasc Dis 2017; 60:435-449. [DOI: 10.1016/j.pcad.2017.10.002] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 10/29/2017] [Indexed: 11/25/2022]
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24
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Deng M, Chen DW, Dong YF, Lu P, Zhan BM, Xu JQ, Ji XX, Li P, Cheng XS. Independent association between age and circadian systolic blood pressure patterns in adults with hypertension. J Clin Hypertens (Greenwich) 2017; 19:948-955. [PMID: 28736895 DOI: 10.1111/jch.13057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 05/29/2017] [Accepted: 06/04/2017] [Indexed: 01/12/2023]
Affiliation(s)
- Ming Deng
- Department of Cardiovascular Medicine; The Second Affiliated Hospital of Nanchang University; Nanchang China
| | - Da-Wei Chen
- Department of Cardiovascular Medicine; The Second Affiliated Hospital of Nanchang University; Nanchang China
| | - Yi-Fei Dong
- Department of Cardiovascular Medicine; The Second Affiliated Hospital of Nanchang University; Nanchang China
- Key Laboratory of Molecular Biology in Jiangxi Province; Nanchang China
| | - Peng Lu
- Department of Cardiovascular Medicine; The Second Affiliated Hospital of Nanchang University; Nanchang China
| | - Bi-Ming Zhan
- Department of Cardiovascular Medicine; The Second Affiliated Hospital of Nanchang University; Nanchang China
| | - Jian-Qing Xu
- Department of Cardiovascular Medicine; The Second Affiliated Hospital of Nanchang University; Nanchang China
| | - Xi-Xin Ji
- Department of Cardiovascular Medicine; The Second Affiliated Hospital of Nanchang University; Nanchang China
| | - Ping Li
- Department of Cardiovascular Medicine; The Second Affiliated Hospital of Nanchang University; Nanchang China
| | - Xiao-Shu Cheng
- Department of Cardiovascular Medicine; The Second Affiliated Hospital of Nanchang University; Nanchang China
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