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Date Published: 02/12/2023
Abstract Views: 123
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DOI: https://doi.org/10.51298/vmj.v532i2.7388
Issue
Vol. 532 No. 2 (2023): Vietnam Medical Journal
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Các bài báo
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Nam , T. V., Truong , H. H., & Thuan , L. T. B. (2023). NON-DIPPING BLOOD PRESSURE PATTERNS AND ASSOCIATED TARGET ORGAN DAMAGE IN ELDERLY HYPERTENSIVE PATIENTS. Vietnam Medical Journal, 532(2). https://doi.org/10.51298/vmj.v532i2.7388

NON-DIPPING BLOOD PRESSURE PATTERNS AND ASSOCIATED TARGET ORGAN DAMAGE IN ELDERLY HYPERTENSIVE PATIENTS

Tran Van Nam 1, Huy Hoang Truong 2,, Le Thi Bich Thuan 3
1 Becamex International Hospital
2 Pham Ngoc Thach University of Medicine
3 Hue University of Medicine and Pharmacy

Main Article Content

Abstract

Background: Older adults with hypertension face an increased risk of adverse cardiovascular outcomes, emphasizing the importance of target organ damage (TOD) in their treatment. The non-dipping blood pressure (BP) pattern, characterized by inadequate reduction of nocturnal BP (less than 10-20%), is associated with a higher likelihood of TOD in individuals with essential hypertension. This study aimed to examine the characteristics of non-dipping BP patterns among elderly individuals with essential hypertension and evaluate their associations with TOD. Methods: A descriptive cross-sectional study was conducted, involving 96 patients aged ≥60 years (mean age 70.9 ± 7.9 years, 35.4% male). Participants underwent routine clinical and laboratory assessments, including clinic and 24-hour ambulatory blood pressure monitoring. TOD was defined as the presence of left ventricular (LV) hypertrophy, renal impairment, or proteinuria. Results: Non-dipping patterns for systolic and diastolic BP were observed in 36 (36.5%) and 41 (42.7%) patients, respectively. TOD was present in 61 (63.5%) patients. Non-dipping systolic patients exhibited lower rates of diabetes mellitus (37.1% vs. 81.3%, p=0.006), dyslipidemia (68.6% vs. 100%, p=0.011), higher levels of creatinine (median 85.6, interquartile range [IQR] 72.1-101 vs. 70.8, IQR 62.4-78.3 µmol/l, p=0.012), and higher LV mass index (median 106.6, IQR 96.4-148.4 vs. 93.7, IQR 72.9-111.5 g/m2, p=0.028) compared to dipping patients. Non-dipping diastolic patients had a lower prevalence of dyslipidemia (73.2% vs. 100%, p=0.048) and a lower body mass index (median 23, IQR 19.73-25 vs. 25.26, IQR 22.54-27.17 kg/m2, p=0.013). Multivariate analysis, after adjusting for cardiovascular risk, showed that non-dipping patterns (both systolic and diastolic) were associated with TOD (odds ratio 7.21; 95% confidence interval 1.47-35.36, p=0.015). Conclusion. Our study underscores the significant association between non-dipping blood pressure patterns and TOD in elderly individuals with essential hypertension. The notable prevalence of non-dipping patterns emphasizes the clinical importance of monitoring and managing these patterns in clinical practice.

Article Details

Keywords

ambulatory blood pressure monitoring, blood pressure patterns, dipper, elderly, hypertension, non-dipper, target organ damage.

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