| الوصف: |
Introduction/Objectives: Nocturnal dipping profile, is a physiological blood pressure drop of 10-20% during the night. Non-dipping profile is considered to be a cardio and cerebrovascular risk factor. There is no consensus on which medication has the greatest impact on restoring the nocturnal drop. Participants, Materials/Methods: 233 patients from the age of 40 (108 male, 125 female) with hypertensive crisis (>180/120mmHg) were observed at the Emergency department in Clinical hospital Merkur from January to November 2019. Patients were divided in five age groups as decades starting from the age of 40 and in ten groups depending of hypertensive medication (ACEi, ARB, beta blockers, calcium channel blockers (CCB), diuretics, moxonidine, ACEi + CCB, ACEi + CCB + diuretics with and without beta blockers and moxonidine). 24-hour ABPM put patients in a category depending on the night dipping profile. Results: Hypertensive crisis was more common in women (52.69%). Mean age was 65.85 years, BMI 30.62kg/m2. There were 26.9% dippers with no difference between genders. Prevalence of the hypertensive crisis in women is more prominent after the age of 65 compared to men of the same age. By using antihypertensive monotherapy, the percentage of hypertensive encephalopathy and chronic vascular changes were 100.00%, 50.00%, 41.66%, 33.33%, 21.05%. Using combination of ACEi + CBB + diuretic significantly decreased the number to 0%, 18.47%, 21.05%, 25.00%, 33.33%. Observing the nocturnal dipping profile, the biggest number of non-dippers was found in patients who took ARBs, diuretics and/or calcium channel blockers (+14.50%). The smallest number of non-dippers was in patients who took ACEi in combination with moxonidine (-20.07%). Conclusions: Our study presented hypertensive brain damage episodes in non-dippers and females. There were no differences between genders in the non-dipping incidence. Combinations of all antihypertensive medication showed benefit over monotherapy, reduced brain damage and thus improved the quality of life of the patient. |
