Abstract
Purpose: The aim of this study was to evaluate the relationship between orthostatic hypotension (OH), defined as a decrease in systolic blood pressure (SBP) ≥20 mmHg and/or a decrease in diastolic blood pressure (DBP) ≥10 mmHg, and 24-h ambulatory BP profile in elderly hypertensive type 2 diabetic patients. Methods: After a 2-week antihypertensive wash-out period, 200 hypertensive well-controlled diabetic outpatients, aged 65–75 years, underwent a clinical examination, including BP measurements, ECG, 24-h ABP monitoring (ABPM), an orthostatic test, and three tests for cardiovascular autonomic function assessment [deep breathing, heart rate (HR) variability, resting HR]. Results: According to their nighttime BP profile, patients were divided into three groups: dippers (n = 86) (BP fall during nighttime ≥10 %), non-dippers (n = 80) (BP fall during nighttime 0–10 %), and reverse dippers (n = 34) (nighttime BP > daytime BP). Orthostatic test produced a significantly greater orthostatic SBP fall in dippers and even more in reverse dippers. In these latter, a significant fall was observed also in DBP. Prevalence of OH was 9.3 % in dippers, 30 % in non-dippers, and 79.4 % in reverse dippers. Conclusions: In elderly hypertensive type 2 diabetics, a blunted nocturnal BP fall is associated with OH and autonomic dysfunction. These data suggest that ABPM should be performed in the assessment of hypertensive diabetic patients in whom the cardiovascular dysautonomia is suspected or the signs of it are present (such as OH).
| Original language | English |
|---|---|
| Pages (from-to) | 433-439 |
| Number of pages | 7 |
| Journal | Clinical Autonomic Research |
| Volume | 26 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Dec 1 2016 |
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Keywords
- Cardiac dysautonomia
- Diabetes
- Elderly
- Hypertension
- Orthostatic hypotension
ASJC Scopus subject areas
- Endocrine and Autonomic Systems
- Clinical Neurology
Cite this
Twenty-four-hour blood pressure profile, orthostatic hypotension, and cardiac dysautonomia in elderly type 2 diabetic hypertensive patients. / Costa, Alfredo; Bosone, Daniele; Ramusino, Matteo Cotta; Ghiotto, Natascia; Guaschino, Elena; Zoppi, Annalisa; D’Angelo, Angela; Fogari, Roberto.
In: Clinical Autonomic Research, Vol. 26, No. 6, 01.12.2016, p. 433-439.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Twenty-four-hour blood pressure profile, orthostatic hypotension, and cardiac dysautonomia in elderly type 2 diabetic hypertensive patients
AU - Costa, Alfredo
AU - Bosone, Daniele
AU - Ramusino, Matteo Cotta
AU - Ghiotto, Natascia
AU - Guaschino, Elena
AU - Zoppi, Annalisa
AU - D’Angelo, Angela
AU - Fogari, Roberto
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Purpose: The aim of this study was to evaluate the relationship between orthostatic hypotension (OH), defined as a decrease in systolic blood pressure (SBP) ≥20 mmHg and/or a decrease in diastolic blood pressure (DBP) ≥10 mmHg, and 24-h ambulatory BP profile in elderly hypertensive type 2 diabetic patients. Methods: After a 2-week antihypertensive wash-out period, 200 hypertensive well-controlled diabetic outpatients, aged 65–75 years, underwent a clinical examination, including BP measurements, ECG, 24-h ABP monitoring (ABPM), an orthostatic test, and three tests for cardiovascular autonomic function assessment [deep breathing, heart rate (HR) variability, resting HR]. Results: According to their nighttime BP profile, patients were divided into three groups: dippers (n = 86) (BP fall during nighttime ≥10 %), non-dippers (n = 80) (BP fall during nighttime 0–10 %), and reverse dippers (n = 34) (nighttime BP > daytime BP). Orthostatic test produced a significantly greater orthostatic SBP fall in dippers and even more in reverse dippers. In these latter, a significant fall was observed also in DBP. Prevalence of OH was 9.3 % in dippers, 30 % in non-dippers, and 79.4 % in reverse dippers. Conclusions: In elderly hypertensive type 2 diabetics, a blunted nocturnal BP fall is associated with OH and autonomic dysfunction. These data suggest that ABPM should be performed in the assessment of hypertensive diabetic patients in whom the cardiovascular dysautonomia is suspected or the signs of it are present (such as OH).
AB - Purpose: The aim of this study was to evaluate the relationship between orthostatic hypotension (OH), defined as a decrease in systolic blood pressure (SBP) ≥20 mmHg and/or a decrease in diastolic blood pressure (DBP) ≥10 mmHg, and 24-h ambulatory BP profile in elderly hypertensive type 2 diabetic patients. Methods: After a 2-week antihypertensive wash-out period, 200 hypertensive well-controlled diabetic outpatients, aged 65–75 years, underwent a clinical examination, including BP measurements, ECG, 24-h ABP monitoring (ABPM), an orthostatic test, and three tests for cardiovascular autonomic function assessment [deep breathing, heart rate (HR) variability, resting HR]. Results: According to their nighttime BP profile, patients were divided into three groups: dippers (n = 86) (BP fall during nighttime ≥10 %), non-dippers (n = 80) (BP fall during nighttime 0–10 %), and reverse dippers (n = 34) (nighttime BP > daytime BP). Orthostatic test produced a significantly greater orthostatic SBP fall in dippers and even more in reverse dippers. In these latter, a significant fall was observed also in DBP. Prevalence of OH was 9.3 % in dippers, 30 % in non-dippers, and 79.4 % in reverse dippers. Conclusions: In elderly hypertensive type 2 diabetics, a blunted nocturnal BP fall is associated with OH and autonomic dysfunction. These data suggest that ABPM should be performed in the assessment of hypertensive diabetic patients in whom the cardiovascular dysautonomia is suspected or the signs of it are present (such as OH).
KW - Cardiac dysautonomia
KW - Diabetes
KW - Elderly
KW - Hypertension
KW - Orthostatic hypotension
UR - http://www.scopus.com/inward/record.url?scp=84987648093&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84987648093&partnerID=8YFLogxK
U2 - 10.1007/s10286-016-0381-7
DO - 10.1007/s10286-016-0381-7
M3 - Article
AN - SCOPUS:84987648093
VL - 26
SP - 433
EP - 439
JO - Clinical Autonomic Research
JF - Clinical Autonomic Research
SN - 0959-9851
IS - 6
ER -