title: Relationship of 24-hour ambulatory blood pressure and heart rate with markers of hepatic function in cirrhotic patients.
abstract: BACKGROUND
  There is evidence that in cirrhotic patients, certain hemodynamic parameters, such as blood pressure and heart rate, are related to the severity of liver disease. This study investigated whether non-invasive 24-hour ambulatory blood pressure and heart rate are more closely associated with markers of liver disease severity than conventional office measurements.
  
  
  METHODS
  Ambulatory patients with cirrhosis underwent office blood pressure and heart rate measurements, 24-hour ambulatory blood pressure monitoring and blood laboratory tests.
  
  
  RESULTS
  Fifty-one patients (32 men, mean age 57.4 ± 11.3 years) completed the study. Twenty six patients had compensated liver cirrhosis (group A) and 25 patients had more advanced liver disease (group B). Group A and B patients differed significantly both in ambulatory asleep diastolic blood pressure (p < 0.05) and office diastolic blood pressure (p < 0.01), which were lower in more advanced liver disease. Office blood pressure and heart rate correlations were similar to or even stronger than ambulatory ones. Ambulatory blood pressure and heart rate awake-asleep variation (dipping) showed a relatively flat pattern as markers of liver dysfunction were deteriorating. The strongest correlations were found with both ambulatory and office heart rate, which increased as indicators of severity of liver disease were worsening.
  
  
  CONCLUSIONS
  Heart rate seems to be a more reliable marker of ongoing liver dysfunction than blood pressure. Evaluation of blood pressure and heart rate with 24-hour ambulatory measurement does not seem to offer more information than conventional office measurements.
authors.affiliation: Hypertension Center, 3rd Department of Medicine, University of Athens Medical School, Sotiria General Hospital, 152 Mesogeion Avenue, 11527, Athens, Greece.
authors.forename: Dimitris G
authors.initials: DG
authors.lastname: Tzamouranis
authors.forename: Alexandra
authors.initials: A
authors.lastname: Alexopoulou
authors.forename: Spyros P
authors.initials: SP
authors.lastname: Dourakis
authors.forename: George S
authors.initials: GS
authors.lastname: Stergiou
mesh_terms: D000368:Aged; D015415:Biomarkers; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers