Is night-time hypertension worse than daytime hypertension? A study on cardiac damage in a general population: The PAMELA study

C. Cuspidi, R. Facchetti, M. Bombelli, C. Sala, M. Tadic, G. Grassi, G. Mancia

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Abstract

Aim: Scanty information is available about the association of isolated daytime hypertension (IDH) and isolated nighttime hypertension (INH) with subclinical cardiac damage in the general population. We examined this issue in patients enrolled in the Pressioni Arteriose Monitorate E Loro Associazioni study. Methods: The analysis included 2021 participants with valid ambulatory blood pressure (BP) monitoring at baseline evaluation. IDH and INH were defined according to current guidelines. Subclinical organ damage was assessed by validated electrocardiographic and echocardiographic criteria. Results: A total of 1258 patients (62.3%) had daytime/night-time normotension, 376 (18.6%) daytime/nighttime hypertension, 231 (11.4%) INH and 156 (7.7%) IDH, respectively. Participants with hypertension, compared with their normotensive counterparts were older, included a higher fraction of men, had higher BMI, LDL cholesterol, triglyceride and glucose levels and exhibited a greater subclinical cardiac involvement. Furthermore, INH and IDH patients showed a similar degree of cardiac damage (i.e. left ventricular mass index: 89 ±18 vs 90±20g/m2), intermediate between normotensive (82±19g/m2) and day-night hypertensive patients (99±24g/m2). Conclusion: The present study shows that IDH and INH exert similar detrimental effects on cardiac structure. In a practical perspective, appropriate antihypertensive chrono-therapeutic approaches in these opposite ambulatory hypertensive subtypes may have important implications in cardiovascular prevention. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Original languageEnglish
Pages (from-to)506-512
Number of pages7
JournalJournal of Hypertension
Volume35
Issue number3
DOIs
Publication statusPublished - 2017

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Hypertension
Population
Ambulatory Blood Pressure Monitoring
LDL Cholesterol
Antihypertensive Agents
Guidelines
Glucose
Health

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Is night-time hypertension worse than daytime hypertension? A study on cardiac damage in a general population: The PAMELA study. / Cuspidi, C.; Facchetti, R.; Bombelli, M.; Sala, C.; Tadic, M.; Grassi, G.; Mancia, G.

In: Journal of Hypertension, Vol. 35, No. 3, 2017, p. 506-512.

Research output: Contribution to journalArticle

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title = "Is night-time hypertension worse than daytime hypertension? A study on cardiac damage in a general population: The PAMELA study",
abstract = "Aim: Scanty information is available about the association of isolated daytime hypertension (IDH) and isolated nighttime hypertension (INH) with subclinical cardiac damage in the general population. We examined this issue in patients enrolled in the Pressioni Arteriose Monitorate E Loro Associazioni study. Methods: The analysis included 2021 participants with valid ambulatory blood pressure (BP) monitoring at baseline evaluation. IDH and INH were defined according to current guidelines. Subclinical organ damage was assessed by validated electrocardiographic and echocardiographic criteria. Results: A total of 1258 patients (62.3{\%}) had daytime/night-time normotension, 376 (18.6{\%}) daytime/nighttime hypertension, 231 (11.4{\%}) INH and 156 (7.7{\%}) IDH, respectively. Participants with hypertension, compared with their normotensive counterparts were older, included a higher fraction of men, had higher BMI, LDL cholesterol, triglyceride and glucose levels and exhibited a greater subclinical cardiac involvement. Furthermore, INH and IDH patients showed a similar degree of cardiac damage (i.e. left ventricular mass index: 89 ±18 vs 90±20g/m2), intermediate between normotensive (82±19g/m2) and day-night hypertensive patients (99±24g/m2). Conclusion: The present study shows that IDH and INH exert similar detrimental effects on cardiac structure. In a practical perspective, appropriate antihypertensive chrono-therapeutic approaches in these opposite ambulatory hypertensive subtypes may have important implications in cardiovascular prevention. Copyright {\circledC} 2017 Wolters Kluwer Health, Inc. All rights reserved.",
author = "C. Cuspidi and R. Facchetti and M. Bombelli and C. Sala and M. Tadic and G. Grassi and G. Mancia",
note = "Cited By :2 Export Date: 31 October 2017 CODEN: JOHYD Correspondence Address: Cuspidi, C.; Istituto Auxologico Italiano IRCCS, University of Milano, Fondazione Ospedale Maggiore Policlinico, Clinical Research Unit, Viale della Resistenza 23, Italy; email: cesare.cuspidi@unimib.it",
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T1 - Is night-time hypertension worse than daytime hypertension? A study on cardiac damage in a general population: The PAMELA study

AU - Cuspidi, C.

AU - Facchetti, R.

AU - Bombelli, M.

AU - Sala, C.

AU - Tadic, M.

AU - Grassi, G.

AU - Mancia, G.

N1 - Cited By :2 Export Date: 31 October 2017 CODEN: JOHYD Correspondence Address: Cuspidi, C.; Istituto Auxologico Italiano IRCCS, University of Milano, Fondazione Ospedale Maggiore Policlinico, Clinical Research Unit, Viale della Resistenza 23, Italy; email: cesare.cuspidi@unimib.it

PY - 2017

Y1 - 2017

N2 - Aim: Scanty information is available about the association of isolated daytime hypertension (IDH) and isolated nighttime hypertension (INH) with subclinical cardiac damage in the general population. We examined this issue in patients enrolled in the Pressioni Arteriose Monitorate E Loro Associazioni study. Methods: The analysis included 2021 participants with valid ambulatory blood pressure (BP) monitoring at baseline evaluation. IDH and INH were defined according to current guidelines. Subclinical organ damage was assessed by validated electrocardiographic and echocardiographic criteria. Results: A total of 1258 patients (62.3%) had daytime/night-time normotension, 376 (18.6%) daytime/nighttime hypertension, 231 (11.4%) INH and 156 (7.7%) IDH, respectively. Participants with hypertension, compared with their normotensive counterparts were older, included a higher fraction of men, had higher BMI, LDL cholesterol, triglyceride and glucose levels and exhibited a greater subclinical cardiac involvement. Furthermore, INH and IDH patients showed a similar degree of cardiac damage (i.e. left ventricular mass index: 89 ±18 vs 90±20g/m2), intermediate between normotensive (82±19g/m2) and day-night hypertensive patients (99±24g/m2). Conclusion: The present study shows that IDH and INH exert similar detrimental effects on cardiac structure. In a practical perspective, appropriate antihypertensive chrono-therapeutic approaches in these opposite ambulatory hypertensive subtypes may have important implications in cardiovascular prevention. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

AB - Aim: Scanty information is available about the association of isolated daytime hypertension (IDH) and isolated nighttime hypertension (INH) with subclinical cardiac damage in the general population. We examined this issue in patients enrolled in the Pressioni Arteriose Monitorate E Loro Associazioni study. Methods: The analysis included 2021 participants with valid ambulatory blood pressure (BP) monitoring at baseline evaluation. IDH and INH were defined according to current guidelines. Subclinical organ damage was assessed by validated electrocardiographic and echocardiographic criteria. Results: A total of 1258 patients (62.3%) had daytime/night-time normotension, 376 (18.6%) daytime/nighttime hypertension, 231 (11.4%) INH and 156 (7.7%) IDH, respectively. Participants with hypertension, compared with their normotensive counterparts were older, included a higher fraction of men, had higher BMI, LDL cholesterol, triglyceride and glucose levels and exhibited a greater subclinical cardiac involvement. Furthermore, INH and IDH patients showed a similar degree of cardiac damage (i.e. left ventricular mass index: 89 ±18 vs 90±20g/m2), intermediate between normotensive (82±19g/m2) and day-night hypertensive patients (99±24g/m2). Conclusion: The present study shows that IDH and INH exert similar detrimental effects on cardiac structure. In a practical perspective, appropriate antihypertensive chrono-therapeutic approaches in these opposite ambulatory hypertensive subtypes may have important implications in cardiovascular prevention. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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