دورية أكاديمية
The value of ambulatory blood pressure measurement to detect masked diastolic hypotension in older patients treated for hypertension.
| العنوان: | The value of ambulatory blood pressure measurement to detect masked diastolic hypotension in older patients treated for hypertension. |
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| المؤلفون: | Kleipool EEF; Department of Geriatric/Internal Medicine, Amsterdam UMC, Location VUmc, 1081 HV Amsterdam, The Netherlands., Rozendaal ES; Department of Geriatric/Internal Medicine, Amsterdam UMC, Location VUmc, 1081 HV Amsterdam, The Netherlands., Mahadew SKN; Department of Geriatric/Internal Medicine, Amsterdam UMC, Location VUmc, 1081 HV Amsterdam, The Netherlands., Kramer MHH; Department of Geriatric/Internal Medicine, Amsterdam UMC, Location VUmc, 1081 HV Amsterdam, The Netherlands., van den Born BH; Department of Vascular/Internal Medicine, Amsterdam UMC, Location AMC, 1105 AZ Amsterdam, The Netherlands., Serné EH; Department of Vascular/Internal Medicine, Amsterdam UMC, Location VUmc, 1081 HV Amsterdam, The Netherlands., Peters MJL; Department of Geriatric/Internal Medicine, Amsterdam UMC, Location VUmc, 1081 HV Amsterdam, The Netherlands.; Department of Vascular/Internal Medicine, Amsterdam UMC, Location VUmc, 1081 HV Amsterdam, The Netherlands., Muller M; Department of Geriatric/Internal Medicine, Amsterdam UMC, Location VUmc, 1081 HV Amsterdam, The Netherlands. |
| المصدر: | Age and ageing [Age Ageing] 2021 Jun 28; Vol. 50 (4), pp. 1229-1235. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 0375655 Publication Model: Print Cited Medium: Internet ISSN: 1468-2834 (Electronic) Linking ISSN: 00020729 NLM ISO Abbreviation: Age Ageing Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Oxford : Oxford University Press Original Publication: London, Baillière, Tindall. |
| مواضيع طبية MeSH: | Hypertension*/diagnosis , Hypertension*/drug therapy , Hypertension*/epidemiology , Hypotension*/diagnosis , Hypotension*/drug therapy, Aged ; Antihypertensive Agents/adverse effects ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Cross-Sectional Studies ; Female ; Humans ; Prevalence ; Retrospective Studies |
| مستخلص: | Objective: assess how many patients with low ambulatory diastolic blood pressure (DBP) are not identified when relying on office DBP alone, and thus have 'masked diastolic hypotension'. Design: cross-sectional, retrospective cohort study. Setting: academic hospital. Subjects: 848 patients treated for hypertension who received ambulatory blood pressure monitoring (ABPM). Methods: cut-off value between on- and off-target systolic blood pressure (SBP): 140 mmHg. Cut-off for low office and/or ambulatory DBP: DBP ≤ 70 mmHg. 'Masked diastolic hypotension' was defined as office DBP > 70 mmHg and mean ambulatory DBP ≤ 70 mmHg. Results: mean age of the sample was 60 ± 13 years, 50% was female, 37% had diabetes, 42% preexisting cardiovascular disease (CVD), mean office blood pressure (BP) was 134/79 mmHg. In all patients (n = 848), low office DBP was present in n = 84(10%), while n = 183(22%) had low ambulatory DBP. In all patients with normal-to-high office DBP (n = 764), n = 122(16%) had 'masked diastolic hypotension'. In this group, ambulatory DBP was 14-19 mmHg lower than office DBP. Patients with low ambulatory DBP were older, had more (cardiovascular) comorbidities, and used more (antihypertensive) drugs. Antihypertensive drugs were lowered or discontinued in 30% of all patients with 'masked diastolic hypotension' due to side effects. Conclusions: 'masked diastolic hypotension' is common among patients treated for hypertension, particularly in older patients with CVD (e.g. coronary artery disease, diabetes), patient groups in which the European Society of Cardiology/Hypertension guideline advises to prevent low DBP. Although it remains to be examined at which BP levels the harms of low DBP outweigh the benefits of lowering SBP, our observations are aimed to increase awareness among physicians. (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.) |
| فهرسة مساهمة: | Keywords: ageing, older people; blood pressure; diastolic blood pressure; hypotension |
| المشرفين على المادة: | 0 (Antihypertensive Agents) |
| تواريخ الأحداث: | Date Created: 20210117 Date Completed: 20210806 Latest Revision: 20210806 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1093/ageing/afaa287 |
| PMID: | 33454734 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1468-2834 |
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| DOI: | 10.1093/ageing/afaa287 |