Integrated Blood Pressure Control最新文献

{"title":"Adherence to Lifestyle Modifications and Associated Factors Among Adult Hypertensive Patients Attending Chronic Follow-Up Units of Dessie Referral Hospital, North East Ethiopia, 2020.","authors":"Atsedemariam Andualem,&nbsp;Habtam Gelaye,&nbsp;Yitayish Damtie","doi":"10.2147/IBPC.S275575","DOIUrl":"https://doi.org/10.2147/IBPC.S275575","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a major health problem throughout the world which affects over one billion people due to severe complications and inadequate control. Even though lifestyle modification is one of the most effective ways to prevent and control hypertension, only little emphasis has been given for it compared with treating hypertension with medication. Therefore, the aim of this study was to assess adherence to lifestyle modifications and associated factors among hypertensive patients attending Dessie referral hospital.</p><p><strong>Materials and methods: </strong>Institutional-based cross-sectional study design was conducted among 301 hypertensive patients during May and June, 2020. The study participants were selected with a convenient sampling technique due to the COVID-19 pandemic. Data were collected using pre-tested and structured face to face interviewer-administered questionnaire and checked, cleaned and entered into Epi data version 4.4 and exported to SPSS version 25.0 software for analysis. The associations between independent variables and dependent variable were analyzed using binary logistic regression models.</p><p><strong>Results: </strong>A total of 301 respondents participated in the study yielding a response of 100%. The overall adherence in this study was only 23.6%. Independent predictors of adherence to lifestyle modifications were divorced (AOR=0.35; 95% CI (0.13-0.94)) and widowed (AOR=0.27; 95% CI (0.10-0.75)), secondary school education (AOR=4.85; 95% CI (1.54-15.22)), no regular income (AOR=0.22; 95% CI (0.08-0.65)) or monthly income of ≥3000 ETB (AOR=5.58; 95% CI (2.46-12.66)), having co-morbidities (AOR=2.37; CI (1.23-4.57)), good knowledge about the disease (AOR=1.83; CI (0.92-3.65)) and good self-efficacy (AOR=3.64; CI (1.75-7.55)).</p><p><strong>Conclusion and recommendations: </strong>The overall adherence to recommended lifestyle modifications was very low. The independent predictors were marital status, educational level, monthly income, having co-morbidities, knowledge and self-efficacy. Therefore, multifaceted and collaborative implementation of strategies about lifestyle modifications for hypertension prevention and control are needed to address barriers at the patient, provider, system and community levels.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"13 ","pages":"145-156"},"PeriodicalIF":2.2,"publicationDate":"2020-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S275575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38544178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Hypertension in Ethiopia: A Systematic Review.","authors":"Nanati Legese,&nbsp;Yohannes Tadiwos","doi":"10.2147/IBPC.S276089","DOIUrl":"https://doi.org/10.2147/IBPC.S276089","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is one of the leading causes of disease in the world. This study is a systematic review paper, intended to provide compressive evidence on the prevalence, distribution, determinants, and burden of hypertension in Ethiopia.</p><p><strong>Methods: </strong>A quantitative epidemiological literature review was conducted by searching different articles in different databases, including PubMed, Cochrane, and Google scholar. The search involved population-based, hospital-based, and institution-based studies on hypertension conducted in Ethiopia. All data were extracted independently by two reviewers using data collection formats. Finally, this review included 22 studies.</p><p><strong>Results: </strong>Different studies reported varied prevalence of hypertension because of the differences in participant's mean ages, source population, and study settings. Population-based studies revealed the prevalence of hypertension to be 9.3-30.3%, institution-based studies revealed 7-37%, whereas hospital-based studies revealed 13.2-18.8%. In studies included in this review, about 37-78% of hypertensive patients were not aware of their blood pressure condition. There was a high prevalence of hypertension in urban residents, and different factors were associated with hypertension, including being overweight, family history of hypertension, age, sex, diabetes mellitus, alcohol intake, physical inactivity, and obesity.</p><p><strong>Conclusion and recommendation: </strong>Hypertension was substantially prevalent in Ethiopia, which calls for the implementation of timely and appropriate strategies for the prevention and control of the disease.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"13 ","pages":"135-143"},"PeriodicalIF":2.2,"publicationDate":"2020-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S276089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38546032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic Stiffness and Diastolic Dysfunction in Sprague Dawley Rats Consuming Short-Term Fructose Plus High Salt Diet.","authors":"Dragana Komnenov,&nbsp;Peter E Levanovich,&nbsp;Natalia Perecki,&nbsp;Charles S Chung,&nbsp;Noreen F Rossi","doi":"10.2147/IBPC.S257205","DOIUrl":"https://doi.org/10.2147/IBPC.S257205","url":null,"abstract":"<p><strong>Introduction: </strong>High fructose and salt consumption continues to be prevalent in western society. Existing studies show that a rat model reflecting a diet of fructose and salt consumed by the upper 20th percentile of the human population results in salt-sensitive hypertension mitigated by treatment with an antioxidant. We hypothesized that dietary fructose, rather than glucose, combined with high salt leads to aortic stiffening and decreased renal artery compliance. We also expect that daily supplementation with the antioxidant, 4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl (+T; Tempol), will ameliorate the increase in mean arterial pressure (MAP) and vascular changes.</p><p><strong>Methods: </strong>Male Sprague Dawley rats were studied with either 20% fructose or 20% glucose in the drinking water and normal salt (0.4%) or high salt (4%) in the chow resulting in four dietary groups: fructose normal Fru+NS or high salt (Fru+HS) or glucose with normal (Glu+NS) or high salt (Glu+HS). Tempol (+T) was added to the drinking water in half of the rats in each group for 3 weeks.</p><p><strong>Results: </strong>MAP was significantly elevated and the glucose:insulin ratio was depressed in the Fru+HS. Both parameters were normalized in Fru+HS+T. Plasma renin activity (PRA) and kidney tissue angiotensin II (Ang II) were not suppressed in the high salt groups. Pulse wave velocity (PWV), radial ascending strain, and distensibility coefficient of the ascending aorta were significantly decreased in Fru+HS rats and improved in the Fru+HS+T rats. No differences occurred in left ventricular systolic function, but the ratio of early (E) to late (A) transmitral filling velocities was decreased and renal resistive index (RRI) was higher in Fru+HS rats; antioxidant treatment did not change these indices.</p><p><strong>Discussion: </strong>Thus, short-term consumption of high fructose plus high salt diet by rats results in modest hypertension, insulin resistance, diminished aortic and renal artery compliance, and left ventricular diastolic dysfunction. Antioxidant treatment ameliorates the blood pressure, insulin resistance and aortic stiffness, but not renal artery stiffness and left ventricular diastolic dysfunction.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"13 ","pages":"111-124"},"PeriodicalIF":2.2,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S257205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38595557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approaches to the Management of Hypertension in Resource-Limited Settings: Strategies to Overcome the Hypertension Crisis in the Post-COVID Era.","authors":"Jamario Skeete,&nbsp;Kenneth Connell,&nbsp;Pedro Ordunez,&nbsp;Donald J DiPette","doi":"10.2147/IBPC.S261031","DOIUrl":"https://doi.org/10.2147/IBPC.S261031","url":null,"abstract":"<p><p>The COVID-19 pandemic has changed most aspects of everyday life in both the non-medical and medical settings. In the medical world, the pandemic has altered how healthcare is delivered and has necessitated an aggressive and new coordinated public health approach to limit its spread and reduce its disease burden and socioeconomic impact. This pandemic has resulted in a staggering morbidity and mortality and massive economic and physical hardships. Meanwhile, non-communicable diseases such as hypertension, diabetes mellitus, and cardiovascular disease in general continue to cause significant disease burden globally in the background. Though presently receiving less attention in the public eye than the COVID-19 pandemic, the hypertension crisis cannot be separated from the minds of healthcare providers, policymakers and the general public, as it continues to wreak havoc, particularly in vulnerable populations in resource limited settings. On this background, many of the strategies being employed to combat the COVID-19 pandemic can be used to re-energize and galvanize the fight against hypertension and hopefully bring the public health crisis associated with uncontrolled hypertension to an end.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"13 ","pages":"125-133"},"PeriodicalIF":2.2,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S261031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38595558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admission and Inpatient Mortality of Hypertension Complications in Addis Ababa.","authors":"Abayneh Birlie Zeru,&nbsp;Mikyas Arega Muluneh","doi":"10.2147/IBPC.S268184","DOIUrl":"https://doi.org/10.2147/IBPC.S268184","url":null,"abstract":"<p><strong>Background: </strong>The number of people with undiagnosed, untreated, and uncontrolled hypertension is higher in Ethiopia. This in turn increases the risk of developing complications and hospitalization. This study aimed to assess the prevalence of hypertension complication hospitalization among medical admissions and admission outcomes of hypertension complication patients in the medical ward of Saint Peter Specialized Hospital, Addis Ababa.</p><p><strong>Methods: </strong>We used a hospital-based cross-sectional study. Data were collected by reviewing all medical ward admission logbook records from January 1st, 2018 to December 30th, 2019. An individual patient folder of 308 patients admitted due to hypertension complications was selected for further detailed investigation and then entered into Epi Data version 3.1 and exported to SPSS version 24 statistical software for analysis.</p><p><strong>Results: </strong>Of the total 2728 medical admissions, 308 (11.3%) were patients with hypertension complications. Hypertension complications account for 308 (11.3%) of all medical admissions. Their mean age and length of hospital stay were 59.85 (± 16.36) years and 11.45 (± 11.48) days, respectively. Near to two-third of 196 (63.6%) of them were stroke patients followed by 76 (24.7%) heart disease. Fifty-two (16.9%) hypertension complication patients died at admission which accounts for 52 (14.6%) of all medical ward deaths. As age increases, the risk of death at admission increases by 6.5%. Similarly, the risk of death increased by three-fold for a month increase in the duration of anti-hypertensive drug discontinuation. Rural residents had a 3.5% lesser risk of death than urban patients.</p><p><strong>Conclusion: </strong>Hypertension complications had a significant share of the medical ward mortality rate. Cerebrovascular and cardiovascular complications were common causes of hospitalization and inpatient death. Old age, urban residence, and prolonged duration of anti-hypertensive drug discontinuation increased the risk of death at admission.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"13 ","pages":"103-110"},"PeriodicalIF":2.2,"publicationDate":"2020-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S268184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38425707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Hypertensive Emergency and Associated Factors Among Hospitalized Patients with Hypertensive Crisis: A Retrospective Cross-Sectional Study.","authors":"Desilu Mahari Desta,&nbsp;Dawit Zewdu Wondafrash,&nbsp;Afewerki Gebremeskel Tsadik,&nbsp;Gebremicheal Gebreslassie Kasahun,&nbsp;Segen Tassew,&nbsp;Teklu Gebrehiwot,&nbsp;Solomon Weldegebreal Asgedom","doi":"10.2147/IBPC.S265183","DOIUrl":"https://doi.org/10.2147/IBPC.S265183","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive emergency (HE) is an acute stage of uncontrolled blood pressure which poses a substantial cardiovascular morbidity and mortality in developing countries. In our setting, the prevalence of HE and the characteristics of patients with a hypertensive crisis are not certainly known yet.</p><p><strong>Objective: </strong>The study assessed the prevalence of hypertensive emergency and associated factors among hospitalized patients with hypertensive crisis.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted by reviewing records of patients having a diagnosis of hypertensive crisis with systolic/diastolic blood pressure raised to more than 180/120 mmHg admitted to Ayder Comprehensive Specialized Hospital (ACSH) from September 2018 to August 2019. Patients' medical records with complete information were enrolled consecutively. Socio-demographic, clinical characteristics, and other related variables were collected using a structured data collection tool from patient medical records. Data were entered and analyzed using SPSS version 20. Logistic regression was employed to determine factors associated with HE.</p><p><strong>Results: </strong>A total of 141 patients' records with a diagnosis of a hypertensive crisis were enrolled in the study; the majority were females 77 (54.6%) and residing in the urban setting 104 (73.8%). The mean age of the participants was 58.8 years. HE was found in 42 (29.8%) of patients. Intravenous Hydralazine 39 (27.7%) and oral calcium channel blocker 102 (72.3%) were the prescribed drugs for acute blood pressure reduction in the emergency setting. Surprisingly, patients who had no history of hypertension (adjusted odds ratio (AOR)=2.469; 95% confidence interval (CI): 0.176‒0.933) and female sex (AOR=2.494; 95% CI: 1.111‒5.596) were found to be independently associated factors with HE.</p><p><strong>Conclusion: </strong>The prevalence of HE was found to account a significant proportion of patients. Hence, hypertensive patients should be strictly managed accordingly, and promoting screening programs could reduce the risk of target organ damage.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"13 ","pages":"95-102"},"PeriodicalIF":2.2,"publicationDate":"2020-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S265183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38359643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resistant Hypertension: Where are We Now and Where Do We Go from Here?","authors":"Mansur K Pathan, Debbie L Cohen","doi":"10.2147/IBPC.S223334","DOIUrl":"10.2147/IBPC.S223334","url":null,"abstract":"<p><p>Resistant hypertension is an important subtype of hypertension that leads to an increased risk of cerebrovascular, cardiovascular, and kidney disease. The revised guidelines from the American College of Cardiology and American Heart Association now define resistant hypertension as blood pressure that remains above goal despite use of three maximally titrated anti-hypertensive medications including a diuretic or as a hypertensive patient who requires 4 or more agents for adequate BP control. These agents typically include a calcium-channel blocker, a renin-angiotensin system inhibitor, and a diuretic at maximal or maximally tolerated doses. As recognition of resistant hypertension increases, it is important to distinguish pseudo-resistant or apparent hypertension from true resistant hypertension. Etiologies of apparent resistant hypertension include measurement error and medication non-adherence. The prevalence of true resistant hypertension is likely much lower than reported in the literature when accounting for patients with apparent resistant hypertension. Evaluation of patients with true resistant hypertension includes screening for causes of secondary hypertension and interfering medications. Successful management of resistant hypertension includes lifestyle modification and optimization of medical therapy, often including the use of mineralocorticoid receptor antagonists. Looking ahead at developments in hypertension management, a slew of new device-based therapies are under active development. Of these, renal denervation is the closest to routine clinical application. Further study is needed before these devices can be recommended in the routine treatment of resistant hypertension.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"13 ","pages":"83-93"},"PeriodicalIF":1.5,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/47/ibpc-13-83.PMC7415451.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38269012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Artery Stenosis in the Patient with Hypertension: Prevalence, Impact and Management.","authors":"Rohini Manaktala,&nbsp;Jose D Tafur-Soto,&nbsp;Christopher J White","doi":"10.2147/IBPC.S248579","DOIUrl":"https://doi.org/10.2147/IBPC.S248579","url":null,"abstract":"<p><p>Atherosclerosis is the primary cause of renal artery stenosis. Atherosclerotic renal artery stenosis (ARAS) is associated with three clinical problems: renovascular hypertension, ischemic nephropathy and cardiac destabilization syndrome which pose huge healthcare implications. There is a significant rate of natural disease progression with worsening severity of renal artery stenosis when renal revascularization is not pursued in a timely manner. Selective sub-groups of individuals with ARAS have had good outcomes after percutaneous renal artery stenting (PTRAS). For example, individuals that underwent PTRAS and had improved renal function were reported to have a 45% survival advantage compared to those without improvement in their renal function. Advances in the imaging tools have allowed for better anatomic and physiologic measurements of ARAS. Measuring translesional hemodynamic gradients has allowed for accurate assessment of ARAS severity. Renal revascularization with PTRAS provides a survival advantage in individuals with significant hemodynamic renal artery stenosis lesions. It is important that we screen, diagnosis, intervene with invasive and medical treatments appropriately in these high-risk patients.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"13 ","pages":"71-82"},"PeriodicalIF":2.2,"publicationDate":"2020-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S248579","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38083616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnitude and Determinants of Uncontrolled Blood Pressure Among Adult Hypertensive Patients on Follow-Up at Nekemte Referral Hospital, Western Ethiopia.","authors":"Ginenus Fekadu,&nbsp;Abdi Adamu,&nbsp;Mohammed Gebre,&nbsp;Busha Gamachu,&nbsp;Firomsa Bekele,&nbsp;Muktar Abadiga,&nbsp;Getu Mosisa,&nbsp;Adugna Oluma","doi":"10.2147/IBPC.S245068","DOIUrl":"https://doi.org/10.2147/IBPC.S245068","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is the leading cause of morbidity and mortality among non-communicable diseases. The rate of blood pressure (BP) control among hypertensive patients is poor and the reasons for poor control of BP remain poorly understood globally. Therefore, this study aimed to assess the magnitude and determinants of uncontrolled blood pressure among adult hypertensive patients on follow-up at Nekemte referral hospital (NRH).</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted from February to April 2018 at NRH. BP control status was determined by the average consecutive BP recordings across the 3 months. The data was entered and analyzed using SPSS version 20.0 and p-value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Out of 297 study participants included, the majority were females, 181 (60.9%), and the mean age of the patients was 59.4 ±10.4 years. About half, 137 (46.12%), of the patients had at least one comorbidity and the most common class of anti-hypertensive medication was angiotensin-converting enzyme inhibitors (88.2%). The mean of systolic blood pressure was 132.41± 15.61mmHg, while the mean of diastolic blood pressure was 84.37± 9.32 mmHg. The proportion of participants with optimally controlled BP was 63.6% and 36% were adherent to their medications. Male sex (Adjusted Odd Ratio [AOR]: 1.89, 95% CI: 1.09-4.84), illiteracy (AOR= 1.56, 95% CI: 1.22-6.78), duration of hypertension diagnosis > 10 years (AOR= 2.01, 95% CI: 1.04-16.11), non-adherence (AOR= 3.14, 95% CI: 1.35-10.76) and lack of physical exercise (AOR= 2.8, 95% CI: 1.16-6.74) were positively associated with uncontrolled BP status. Whereas age older than 55 years (AOR= 0.38, 95% CI: 0.11-0.92) was negatively associated with uncontrolled BP.</p><p><strong>Conclusion: </strong>BP control was relatively achieved in about two-third of pharmacologically treated patients. We recommend better health education and care of patients to improve the rate of BP control status.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"13 ","pages":"49-61"},"PeriodicalIF":2.2,"publicationDate":"2020-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S245068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37899913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Nocturnal Hypertension: What Do We Know and What Can We Do?","authors":"Marijana Tadic,&nbsp;Cesare Cuspidi,&nbsp;Guido Grassi,&nbsp;Giuseppe Mancia","doi":"10.2147/IBPC.S223336","DOIUrl":"https://doi.org/10.2147/IBPC.S223336","url":null,"abstract":"<p><p>Nocturnal hypertension has been recognized as a significant risk factor for cardio- and cerebrovascular diseases. Blood pressure (BP) monitoring significantly increased our awareness of nocturnal hypertension and studies revealed its influence on target organ damage. Nocturnal hypertension is associated with nonphysiological 24-h BP patterns, which consider inadequate drop or even increment of nighttime BP in comparison with daytime BP (nondipping and reverse dipping). Nevertheless, investigations showed that nocturnal hypertension was a predictor of adverse outcome independently of circadian BP pattern. There are still many uncertainties regarding diagnosis, mechanisms and treatment of nocturnal hypertension. There is a small difference between American and European guidelines in cutoff values defining nocturnal hypertension. Pathophysiology is also not clear because many conditions such as diabetes, metabolic syndrome, obesity, sleep apnea syndrome, and renal diseases are related to nocturnal hypertension and nonphysiological circadian BP pattern, but mechanisms of nocturnal hypertension still remain speculative. Therapeutic approach is another important issue and chronotherapy provided the best results so far. There are studies which showed that some groups of antihypertensive medications are more effective in regulation of nocturnal BP, but it seems that the timing of drug administration has a crucial role in the reduction of nighttime BP and conversion of circadian patterns from nonphysiologic to physiologic. Follow-up studies are necessary to define clinical benefits of nocturnal BP reduction and restoring unfavorable 24-h BP variations to physiological variant.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"13 ","pages":"63-69"},"PeriodicalIF":2.2,"publicationDate":"2020-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/IBPC.S223336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37899914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}