Lack of nocturnal blood pressure fall in elderly bedridden hypertensive patients with cerebrovascular disease.
To prevent recurrence of cerebrovascular disease (CVD), adequate control of blood pressure (BP) is extremely important for the treatment of hypertensive CVD patients. As absence of the nocturnal fall of BP by the expected 10-20% from daytime levels is reported to exaggerate target organ injury, 24-h ambulatory blood pressure monitoring (ABPM) was conducted, especially to obtain data during nighttime sleep. Forty-eight elderly bedridden chronic phase CVD hypertensive patients (assessed 1-3 mo after CVD accident) participated. As a group, nocturnal BP was higher than diurnal BP, whereas nocturnal pulse rate was lower than diurnal pulse rate. The nocturnal BP fall was blunted in most (∼90%) of the patients. These results suggest that to perform a rational drug treatment, it is essential to do 24-h ABPM before initiation of antihypertensive therapy in elderly bedridden hypertensive CVD patients.
Shin-Uryu Daiichi Hospital, Hokkaido, Japan.
Masato
M
Sasaki
Hitoshi
H
Ando
Akio
A
Fujimura
D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D015924:Blood Pressure Monitors; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000503:physiopathology; D002940:Circadian Rhythm / Q000502:physiology; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000628:therapy; D008297:Male; D010865:Pilot Projects; D020521:Stroke / Q000503:physiopathology; D013997:Time Factors
D000959:Antihypertensive Agents