Mediavilla García Juan Diego, Fernández-Torres Celia, Arroyo Nieto Ascensión, Expósito Ruiz Manuela, Jiménez-Alonso Juan
Unidad de HTA y Lípidos, Servicio de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, España.
Med Clin (Barc). 2009 Feb 14;132(5):180-3. doi: 10.1016/j.medcli.2008.04.001. Epub 2009 Feb 7.
Besides reducing blood pressure, it is important to think about the blood pressure variability that hypertensive patients may present. Indeed, studies suggest that target organ damage is greater in hypertensive people with high blood pressure variability. The purpose of the present study was to determine the blood pressure variability in patients who had not been treated with antihypertensive medication, as well as its relationship with the glomerular filtration.
We included 702 patients with clinical indication for 24h ambulatory blood pressure monitoring.
43.6% of patients had high variability of the blood pressure. These patients had greater levels of 24-h systolic blood pressure, diurnal and night blood pressure and a lower glomerular filtration. The main factors associated with high blood pressure variability were age, years from diagnosis of arterial hypertension, systolic blood pressure and a glomerular filtration smaller than 60ml/min.
A high variability of blood pressure is frequent among hypertensive patients. Since it is not possible to perform ambulatory blood pressure measurement in all them, we should mainly suspect it in old patients and in those with reduced glomerular filtration.
除了降低血压外,考虑高血压患者可能出现的血压变异性也很重要。事实上,研究表明,血压变异性高的高血压患者靶器官损害更严重。本研究的目的是确定未接受抗高血压药物治疗的患者的血压变异性及其与肾小球滤过的关系。
我们纳入了702例有24小时动态血压监测临床指征的患者。
43.6%的患者血压变异性高。这些患者的24小时收缩压、日间和夜间血压水平更高,肾小球滤过率更低。与高血压变异性相关的主要因素是年龄、动脉高血压诊断后的年限、收缩压以及肾小球滤过率小于60ml/分钟。
高血压患者中血压变异性高很常见。由于不可能对所有患者进行动态血压测量,我们应主要怀疑老年患者和肾小球滤过率降低的患者存在血压变异性高的情况。