[Importance of the determination of blood pressure profile in the diagnosis of atherosclerotic cardiovascular disease].
The nocturnal decline of blood pressure (BP) is not observed in autonomic dysfunction (after cardiac transplantation and in patients with diabetic neuropathy) or in patients with atherosclerotic cardiovascular disease. This study evaluated if smoking prematurely alters the blood pressure during the night and if the cumulative risk of hypertension and smoking may additionally alter this nocturnal profile. Three different groups of subjects were studied. In each subject systolic and diastolic BP was recorded, for 24 hours at 15 min intervals, by automatic non-invasive monitoring. Group 1 consisted of 14 normotensive nonsmokers (with a mean age 50, range 38 to 54 years); Group 2 consisted of 14 normotensive heavy smokers (with a mean age 48, range 37 to 52); Group 3 consisted of 14 heavy smokers with mild or moderate hypertension and with left ventricular hypertrophy (with a mean age 51, range 39 to 54 years). We have evaluated particularly the average systolic and diastolic BP during 3 hours of the day and 3 hours of the night, the latter selected from midnight to 3.00 am, when the patients were asleep, and the former selected from 3.00 pm to 6.00 pm when they were engaged in social activities in the hospital. The statistical analysis showed that in normotensive heavy smokers (and in hypertensive smokers) the normal nocturnal decline of BP is not present. This physiologic fall in arterial pressure was normally observed in the group of normotensive nonsmokers. The absence of nocturnal decline of BP may be related to the reduced arterial distensibility secondary to smoking damage and may represent an important and early marker of this vascular alteration.
Artom
A
A
Divisione di Medicina Generale II, Ospedale Santa Corona, Pietra Ligure, SV.
Mela
D
D
Orsoni
F
F
Berton
A
A
Ruffino
C
C
Ricciardi
S
S
D000328:Adult; D001794:Blood Pressure; D015924:Blood Pressure Monitors; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012890:Sleep; D012907:Smoking; D013997:Time Factors
Importanza della determinazione del profilo pressorio nella diagnostica del danno cardiovascolare aterosclerotico.