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2425 Ambulatory blood pressure monitoring: the loss of circadian rhythm The aim of this study is to evaluate the different incidence of cerebro and cardiovascular events between Dippers (D) and Not Dippers (ND). Methods: 130 consecutive pts, 78 M and 52 F, mean age 58± 8 yrs underwent 24 hrs. ambulatory blood pressure monitoring (ABPM) after adequate drugs wash-out: 70 of them resulted D, whilst 60 resulted ND. All pts. underwent even a clinical evaluation, ECG, ECHO, and all routine tests in order to exclude a secondary hypertension. After 1 year the incidence of cerebro and cardiovascular events has been verified. Results: 2 D were affected by nefrovascular hypertension; 6 ND presented secondary hypertension (4 nefrovascular, 1 Conn’s and 1 Cushing ‘s syndromes) . Among D (68 pts.) with essential hypertension, 9 (13%) had vascular events: 4 AMI, 2 unstable angina, 3 ictus cerebri. 11 of them were diabetics. Among ND (54 pts.) 35 (65%) had vascular events: 16 AMI, 4 unstable angina, 9 ictus cerebri, 6 pulmonary edema. 12 pts. were diabetics. Those results indicated an high statistically significant difference between the 2 groups (p < 0.001). The loss of circadian rhythm has therefore a predictive value for cerebro and cardiovascular events: sensibility 81.8%; specificity 81%; positive predictive value 72%; negative predictive value 88% Conclusions: The loss of circadian rhythm is therefore important to detect high- risk patients on whom it would be reasonable to concentrate our attention.

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2012-08-27   |   241 visitas   |   Evalua este artículo 0 valoraciones

Vol. 30 Núm.2. Abril-Junio 2001 Pags. 355-370 Rev Fed Arg Cardiol 2001; 30(2)