[Prognostic value of the degree of night decrease of systolic pressure in patients with mild and moderate forms of hypertension (7-9-year prospective study)].
OBJECTIVE
To study a relationship between a carcadian blood pressure (BP) rhythm and cardiovascular events (CE) during 7-9 year follow-up in males with mild to moderate essential hypertension (EH).


METHODS
50 males (mean age 48.6 +/- 0.7 years) with mild to moderate EH were prospectively followed up for 7-9 years (8.4 +/- 0.1 years). We analysed 24-h BP recordings and protocol of echocardiography performed during the first hospitalization. The patients were divided into three groups: group 1 (n = 18) with normal (10-20%) nocturnal fall of systolic BP (NF SBP) and normal left ventricular mass index (LVMI < 125 g/m2); group 2 (n = 16) with insufficient (< 10%) NF SBP and normal LVMI; group 3 (n = 16) with LVMI > 125 g/m2. In these groups we assessed the prevalence of CE: myocardial infarction (MI), stroke (S), sudden death (SD), new cases of angina pectoris (AP), transient cerebral ischemic attack (TIA).


RESULTS
No significant differences were found between the groups by mean age, body mass index, duration of arterial hypertension, mean 24-h and awake systolic and diastolic BP while significant differences were by nighttime BP profile parameters. During the follow-up 16 CE in 12 patients were documented (3 fatal and 13 nonfatal). In group 1 CE were observed in 1 patient (twice MI), in group 2-7 cases of CE (1 S, 1 TCIA, 2 MI, 2 AP) in 6 patients, in group 3-7 cases (2 MI, 3 TIA, 2 AP) in 5 patients, 3 of them were fatal.


CONCLUSIONS
Insufficient nocturnal fall of SBP (< 10%) is an adverse prognostic factor for cardiovascular morbidity in mild to moderate essential male hypertensives.
Zel 'veian
P A
PA
Oshchepkova
E V
EV
Buniatian
M S
MS
Rogoza
A N
AN
Sergakova
L M
LM
Varakin
Iu Ia
IuIa
Gornostaeva
G V
GV
D000328:Adult; D001794:Blood Pressure; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies