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Ambulatory Daytime And Nighttime Heart Rate Is Significantly Higher In Nondipper Hypertensive Patients
Mustafa Arpacı1, Ejder Kardesoglu1, Omer Yiginer1, Zafer Isılak2, Alper Ucak3, Omer Uz1, Cem Demirbolat4, Yalcın Onem5, Bekir Yılmaz Cingozbay1, Bekir Sıtkı Cebeci11GATA Haydarpasa Education Hospital Cardiology Clinic, Istanbul2Elazıg Military Hospital Cardiology Service
3GATA Haydarpasa Education Hospital Cardiovascular Surgery Clinic, Istanbul
4Goztepe Cardiology Center, Istanbul
5GATA Haydarpasa Education Hospital Department of Internal Medicine, Istanbul
Objectives Nondipping status; probably a result of sympathetic hyperacitivity; is clinically associated with poor prognosis. In this study we aimed to evaluate the variation of daytime and nighttime heart rate among dipper and nondipper patients probably due to sympathetic hyperactivity. Material and Method 116 patients were enrolled and performed 24 hour ambulatory blood pressure monitoring. 24-hour daytime and nighttime systolic and diastolic blood pressures and heart rates were compared between the dipper and non dipper hypertensive patients. Statistical analysis was performed by Independent Samples t test using SPSS 11.0 for Windows. Results Daytime heart rates were higher in nondipper patients than dipper patients (78,3±9 vs 75,2±9, p=0.1>0.05), but the difference was not statistically significant. Also nighttime heart rates were significantly higher in non dipper patients (65,9±8,7 vs 61,7±7,8, p=0.02<0.05). Nighttime heart rate dipping is significantly lower in nondipper patients (%14.2±6.1 vs %17.8±5.9 p<0.05). Conclusion Increased heart rates of daytime and nighttime period in nondipper patients are clinical finding of sympathetic hyperactivity which was accounted for nondipping. Since nondipping status is closely associated increased risk for cardiovascular events, effective treatment of nondipper patients and modifications in drug therapy may reduce cardiovascular morbidity and mortality.
Keywords: Hypertension, nondipping, heart rate, ambulatoryAmbulatuvar Gündüz ve Gece Kalp Hızı Nondipper Hipertansif Hastalarda Anlamlı Derecede Yüksektir
Mustafa Arpacı1, Ejder Kardesoglu1, Omer Yiginer1, Zafer Isılak2, Alper Ucak3, Omer Uz1, Cem Demirbolat4, Yalcın Onem5, Bekir Yılmaz Cingozbay1, Bekir Sıtkı Cebeci11GATA Haydarpasa Education Hospital Cardiology Clinic, Istanbul2Elazıg Military Hospital Cardiology Service
3GATA Haydarpasa Education Hospital Cardiovascular Surgery Clinic, Istanbul
4Goztepe Cardiology Center, Istanbul
5GATA Haydarpasa Education Hospital Department of Internal Medicine, Istanbul
Amaç Nondipping durumu olasılıkla sempatik hiperaktivitenin bir sonucu olup klinik olarak kötü bir prognoz ile iliskilidir. Bu çalısmada nondipper ve dipper hipertansif hastalarda gece ve gündüz kalp hızı değisimini incelemeyi amaçladık. Materyal ve Metod 116 hasta çalısmaya alındı ve 24 saatlik ambulatuvar kan basıncı monitorizasyonu yapıldı. 24 saatlik gündüz ve gece sistolik ve diyastolik kan basınçları ve kalp hızları dipper ve non dipper hastalar arasında karsılastırıldı. Dstatistiki analizler Independent Samples t test ile SPSS 11.0 Windows paket programı kullanılarak yapıldı. Bulgular Gündüz kalp hızı nondipper hastalarda dipper hastalara göre yüksek izlendi (78,3±9 ile 75,2±9, p=0.1>0.05) ancak istatistiki olarak anlamlı değildi. Gece kalp hızı ise nondipper hastalarda anlamlı derecede yüksek izlendi (65,9±8,7 ile 61,7±7,8, p=0.02<0.05). Gece kalp hızı düsüsü nondipper hastalarda anlamlı derecede düsük izlendi (%14,2±6,1 ile %17,8±5,9 p<0.05). Sonuç Nondipper hastalarda gündüz ve gece kalp hızı yüksekliği nondipping durumundan da sorumlu tutulan sempatik hiperaktivitenin bir klinik bulgusudur. Nondipping kardyovasküler olay artısı ile iliskili olduğundan dolayı nondipper hastaların etkin tedavisi ve ilaç tedavisi modifikasyonu kardiyovasküler mortalite ve morbiditeyi azaltabilir.
Anahtar Kelimeler: Hipertansiyon, nondipping, kalp hızı, ambulatuvarManuscript Language: English