Objective: To determine the prevalence of circadian BP patterns and to assess factors associated with the non-dipping pattern in untreated and treated hypertensive patients, studied separately. Methods: Clinical data ...Objective: To determine the prevalence of circadian BP patterns and to assess factors associated with the non-dipping pattern in untreated and treated hypertensive patients, studied separately. Methods: Clinical data and ABPM were obtained from 52 untreated and 168 treated hypertensive patients referred for ABPM to Monkole Hospital in Kinshasa. Twenty-four ABPM was performed using an oscillometric device. Non-dipping pattern encompasses non-dipping (nocturnal systolic BP dip less than 10% of daytime systolic BP) and reverse dipping (mean night SBP higher than the day SBP). Results: the prevalence of non-dipping pattern was 75% (63.5% non-dipping and 11.5% reverse dipping) and 70% (60.1% non-dipping and 10.1% reverse dipping) in untreated and treated hypertensive patients, respectively. Advanced age (adjusted OR 1.80;95%CI 1.96 - 3.38;p = 0.015), female sex (adjusted OR 2.28;95%CI 1.19 - 4.36;p = 0.013), diabetes (adjusted OR 5.06;95%CI 1.38 - 6.95;p = 0.014), reduced kidney function (adjusted OR 3.10;95%CI 1.50 - 6.43;p = 0.018), inflammation (adjusted OR 2.65;95%CI 1.76 - 6.48;p = 0.031), LVH (adjusted OR 4.45;95%CI 1.78 - 7.67;p = 0.024) and antihypertensive therapy (adjusted OR 0.19;95%CI 0.12 - 0.64;p = 0.018) emerged as the main independent factors significantly associated with the non-dipping pattern in the study population. Conclusion: the non-dipping pattern was a common finding in studied patients and associated with traditional and emerging risk factors suggesting that this abnormal pattern could be a marker of high cardiovascular risk.展开更多
Background: Although systemic hypertension is rarely seen in steady state sickle cell disease (SCD), relative hypertension has been reported to be associated with an increased risk of cardiovascular and renal complica...Background: Although systemic hypertension is rarely seen in steady state sickle cell disease (SCD), relative hypertension has been reported to be associated with an increased risk of cardiovascular and renal complications. Objective: To determine the prevalence of BP patterns and assess factors associated with relative hypertension insickle cell anemia (SCA) adult patients. Methods: Clinical data and office BP were obtained from 103 consecutive steady-state SCA adult patients (mean age 26 ± 7.9 years, 66% females, 22.3% on hydroxyurea) attending four healthcare centers providing SCD-specific care in Kinshasa. Seated BP was measured using an automated electronic device. Three consecutive blood pressure measurements were taken with 2 minutes interval between readings and the average of the 2 last readings was considered for the analyses. Normal BP, relative hypertension and systemic hypertension were defined as BP 120/70 mmHg, 120 - 139/70 - 89 mmHg and ≥140/90 mmHg, respectively. Results: Normal BP, relative hypertension and systemic hypertension were observed in 56 (54%), 43(42%) and 4 (4%) of SCA patients, respectively. In multivariate analysis, factors associated with relative hypertension were leg ulcer (aOR 2.05;95%CI 1.77 - 5.18;p = 0.016), central obesity (aOR 3.32;95%CI 1.28 - 6.24;p = 0.001), smoking (aOR 5.02;95%CI 1.51 - 9.50;p = 0.017), and microalbumiuria (aOR 3.44;95%CI 1.44 - 5.76;p = 0.035). Conclusion: Relative hypertension was a common finding in the present case series and associated with traditional cardiovascular risk factor as well as factors specific to SCD highlighting the need for measures to prevent its progression towards systemic hypertension and associated cardiovascular and renal disease.展开更多
文摘Objective: To determine the prevalence of circadian BP patterns and to assess factors associated with the non-dipping pattern in untreated and treated hypertensive patients, studied separately. Methods: Clinical data and ABPM were obtained from 52 untreated and 168 treated hypertensive patients referred for ABPM to Monkole Hospital in Kinshasa. Twenty-four ABPM was performed using an oscillometric device. Non-dipping pattern encompasses non-dipping (nocturnal systolic BP dip less than 10% of daytime systolic BP) and reverse dipping (mean night SBP higher than the day SBP). Results: the prevalence of non-dipping pattern was 75% (63.5% non-dipping and 11.5% reverse dipping) and 70% (60.1% non-dipping and 10.1% reverse dipping) in untreated and treated hypertensive patients, respectively. Advanced age (adjusted OR 1.80;95%CI 1.96 - 3.38;p = 0.015), female sex (adjusted OR 2.28;95%CI 1.19 - 4.36;p = 0.013), diabetes (adjusted OR 5.06;95%CI 1.38 - 6.95;p = 0.014), reduced kidney function (adjusted OR 3.10;95%CI 1.50 - 6.43;p = 0.018), inflammation (adjusted OR 2.65;95%CI 1.76 - 6.48;p = 0.031), LVH (adjusted OR 4.45;95%CI 1.78 - 7.67;p = 0.024) and antihypertensive therapy (adjusted OR 0.19;95%CI 0.12 - 0.64;p = 0.018) emerged as the main independent factors significantly associated with the non-dipping pattern in the study population. Conclusion: the non-dipping pattern was a common finding in studied patients and associated with traditional and emerging risk factors suggesting that this abnormal pattern could be a marker of high cardiovascular risk.
文摘Background: Although systemic hypertension is rarely seen in steady state sickle cell disease (SCD), relative hypertension has been reported to be associated with an increased risk of cardiovascular and renal complications. Objective: To determine the prevalence of BP patterns and assess factors associated with relative hypertension insickle cell anemia (SCA) adult patients. Methods: Clinical data and office BP were obtained from 103 consecutive steady-state SCA adult patients (mean age 26 ± 7.9 years, 66% females, 22.3% on hydroxyurea) attending four healthcare centers providing SCD-specific care in Kinshasa. Seated BP was measured using an automated electronic device. Three consecutive blood pressure measurements were taken with 2 minutes interval between readings and the average of the 2 last readings was considered for the analyses. Normal BP, relative hypertension and systemic hypertension were defined as BP 120/70 mmHg, 120 - 139/70 - 89 mmHg and ≥140/90 mmHg, respectively. Results: Normal BP, relative hypertension and systemic hypertension were observed in 56 (54%), 43(42%) and 4 (4%) of SCA patients, respectively. In multivariate analysis, factors associated with relative hypertension were leg ulcer (aOR 2.05;95%CI 1.77 - 5.18;p = 0.016), central obesity (aOR 3.32;95%CI 1.28 - 6.24;p = 0.001), smoking (aOR 5.02;95%CI 1.51 - 9.50;p = 0.017), and microalbumiuria (aOR 3.44;95%CI 1.44 - 5.76;p = 0.035). Conclusion: Relative hypertension was a common finding in the present case series and associated with traditional cardiovascular risk factor as well as factors specific to SCD highlighting the need for measures to prevent its progression towards systemic hypertension and associated cardiovascular and renal disease.
