[Ambulatory blood pressure in hypertension with dysautonomia].
The purpose of the study was to evaluate the interest of ambulatory blood pressure (BP) recording (ABPR) in the management of arterial hypertension (AH) with dysautonomia. The study concerned 8 hypertensive patients (pts), 5 men, 3 females 52 +/- 10 years old, with orthostatic hypotension (OH): BP was 162 +/- 19/87 +/- 16 mmHg and 129 +/- 15/76 +/- 8 mmHg in lying and standing position respectively. In two cases AH was associated with a central degenerative disorder whereas the six other pts had a diabetic dysautonomia: bad metabolic control (HBA1c 14.4 +/- 2.7%), and incipient or over nephropathy (4 pts). ABPR was performed in all pts during 24 hours (space-labs system). In these hypertensive pts with OH, the mean 24 hour-BP was surprisingly normal at 128 +/- 11/76 +/- 6 mmHg. ABPR demonstrated the loss of nocturnal decline in BP: diurnal and nocturnal BP were respectively 125 +/- 13/74 +/- 6 mmHg and 133 +/- 16/78 +/- 10 mmHg (NS). 6 of 8 pts had an increase in BP at night resulting for the population (n = 8) in a nocturnal increase (%) of + 5.6%, this pattern widely differs from controls--13%. The decrease in heart rate during sleep was blunted but significant from 89 +/- 9 b/min to 81 +/- 9 b/min (p 0.01). Diurnal and nocturnal BP variability (V), assessed by variation coefficient were not significantly different: SBP-V was 10.3 +/- 6.4% day and 12.3 +/- 4.2% night, DBP-V 7.5 +/- 6.3% day and 12.5 +/- 3.1% night.(ABSTRACT TRUNCATED AT 250 WORDS)
Chamontin
B
B
Service de médecine interne, hôpital Purpan, Toulouse.
Barbe
P
P
Begasse
F
F
Ghisolfi
A
A
Amar
J
J
Louvet
J P
JP
Salvador
M
M
D000328:Adult; D000553:Ambulatory Care; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000209:etiology / Q000503:physiopathology*; D001794:Blood Pressure; D015924:Blood Pressure Monitors; D002940:Circadian Rhythm; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D007024:Hypotension, Orthostatic / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged
Pression artérielle ambulatoire au cours de l'hypertension artérielle avec dysautonomie.