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Introducción: Numerosos estudios han establecido tanto la hipertensión arterial como la hipertensión de bata blanca como factores de riesgo cardiovascular. Un ritmo circadiano anómalo de la presión arterial podría aumentar el riesgo cardiovascular. Objetivo: Determinar la existencia de una relación clínicamente relevante entre un ritmo circadiano anómalo de la presión arterial y un incremento del riesgo cardiovascular en pacientes con hipertensión arterial o hipertensión de bata blanca. Material y Método: Estudio descriptivo en 166 pacientes mayores de 18 años del Área Básica de Salud de Balaguer que tuvieran una monitorización ambulatoria de la presión arterial realizada entre junio de 2014 y marzo de 2018 y cumplieran los criterios de inclusión y exclusión. Se realizó un análisis univariado y bivariado de las variables. Resultados: Se obtuvo que en casi todos los promedios de presión arterial nocturna destaca el patrón riser mostrando que el 25% tenía un riesgo cardiovascular mayor o igual al 10%, seguido del dipper extremo 16,67%, dipper 9,4% y no dipper 8,27%. Conclusión: Un ritmo circadiano alterado se relaciona con un riesgo cardiovascular más elevado y un peor control de los factores que conllevan al mismo.
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Referencias
- Franklin SS, Thijs L, Asayama K, Li Y, Hansen TW, Boggia J et al. The Cardiovascular Risk of White-Coat Hypertension. J Am Coll Cardiol 2016;68 (19):2033-43.
- Robles NR. Importancia clínica de la hipertensión de bata blanca. Nefrología 2004;24(1):17-8.
- Abolbashari M. White Coat Hypertension and Cardiovascular Diseases: Innocent or Guilty. Current Cardiology Report 2018;20(4):25.
- Watanabe A, Hirashiki N, Murohara Y, Watanabe N, Kano N, Mori H et al. Abnormal Circadian Blood Pressure Profile as a Prognostic Marker in Patients with Nonischemic Dilated Cardiomyopathy. Cardiology 2017;136:1-9.
- De La Sierra A, Gorostidi M, Banegas JR, Segura J, De La Cruz JJ, Ruilope LM. Nocturnal hypertension or nondipping: Which is better associated with the cardiovascular risk profile? Am J Hypertens 2014; 27(5):680-7.
- Doménech CM, Sobrino J. Hipertensión nocturna. Hipertensión y Riesgo Vascular 2011;28(4):143-8.
- Hansen TW, Li Y, Boggia J, Thijs L, Richart T, Staessen JA. Predictive role of the nighttime blood pressure. Hypertension 2011;57(1):3-10.
- Ayala DE, Domínguez M, Otero A, Ríos MT, Gomara SM, Moya A et al. Morning surge and sleep-time blood pressure as prognostic markers of cardiovascular risk: the hygia project. J Hypertens 2015;33 (1).
- Mediavilla JD, Fernández C, Arroyo A, Jiménez J. Estudio del patrón circadiano de la presión arterial en pacientes hipertensos. An Med Interna 2007; 24(2):61-6.
- Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018;71:127-248.
- Egan BM, Li J, Hutchison FN, Ferdinand KC. Hypertension in the United States, 1999 to 2012: progress toward Healthy People 2020 goals. Circulation 2014;130:1692-9.
- Sousa F, Neves J, Ferreira R, Polonia J, Bastos JM. In hypertension the change from a non-dipper to a dipper pattern is associated with a better cardiovascular prognosis than the persistence within the non-dipper pattern. J Hypertens 2015;33(1).
- Cuspidi C, Giudici V, Negri F, Sala C. Nocturnal nondipping and left ventricular hypertrophy in hypertension: An updated review. Expert Review of Cardiovascular Therapy 2010;8(6):781-92.
- Oliveras A, Armario P, Martell-Clarós N, Ruilope LM, De La Sierra A. Urinary albumin excretion is associated with nocturnal systolic blood pressure in resistant hypertensives. Hypertension 2011;57 (3):556-60.
- Guerrero L, Fernández L, Andúgar J, Casal MC, Campo C, Segura J et al. Prevalencia de Vasculopatía Periférica Subclínica evaluada mediante el índice tobillo/brazo en pacientes con hipertensión arterial. Enferm Nefrol 2003;6(3):209-10.
- Syrseloudis D, Tsioufis C, Andrikou I, Mazaraki A, Thomopoulos C, Mihas C et al. Association of nighttime hypertension with central arterial stiffness and urinary albumin excretion in dipper hypertensive subjects. Hypertens Res 2011;34(1):120-5.
- Sekizuka H, Osada N AY. The Factors Affecting the Non-dipper Pattern in Japanese Patients with Severe Obstructive Sleep Apnea. Intern Med 2018;57 (11):1553-9.
- Mokhlesi B, Hagen EW, Finn LA, Hla KM, Carter JR, Peppard PE. Obstructive sleep apnoea during REM sleep and incident non-dipping of nocturnal blood pressure: A longitudinal analysis of the Wisconsin Sleep Cohort. Thorax 2015;70(11):1062-9.
- Kucukdurmaz Z, Karavelioglu Y, Karapinar H, Gul I, Yilmaz A, Yarlioglues M, et al. Hypertensive response to exercise in dipper and non-dipper normotensive diabetics. Clin Exp Hypertens 2014;36(5):275-9.
- Yuzbashian E, Asgari G. Adherence to low-sodium dietary approaches to stop hypertension-stail diet may decrease the risk of incident chronic kidney disease among high-risk patients, a secondary prevention in prospective cohort study. Nephrol Dial Transplant 2018;33(7):1159-68.
- Song S, Kim J. Gender differences in the association between dietary pattern and the incidence of hypertension in middle-age and older adults. Nutrients 2018;10(2):252.
- Coll B, Betriu A, Feinstein SB, Valdivielso JM, Zamorano JL, Fernández E. Papel de la ecografía carotídea en la reclasificación del riesgo cardiovascular de sujetos de riesgo bajo-intermedio. Rev Esp Cardiol 2013;66(12):929-34.
- Arribas Cobo P, Fernández Fuentes S, Guimerá Ferrer-Sama MA, Herrera Martín E, Martínez Aranda MA. Los efectos de una intervención educativa sobre la ingesta de sal para disminuir la sobrehidratación y la hipertensión arterial en pacientes con hemodiálisis. Enferm Nefrol 2013;16(3):87-8.
- Jones NRV, Forohui NG, Khaw KT, Whareham NJ, Monsivais P. Accordance to the dietary approaches to stop hypertension diet pattern and cardiovascular disease in a British, population-base cohort. Eur J Epidemiol 2018;357:1794.
- Haidari A, Moeini N, Khosravi A. The impact of peer support programme of adherence to the treatment regimen in patients with hypertension. A randomized clinical trial study. Iranian Journal of Nursing Mildwifery Research 2017;22(6):427-30.
- Abel WM, Joyner JS, Cornelius JB, Greer DB. Self-care management strategies use by black women who self-report consistent adherence to antihypertensive medication. Patient Preference and Adherence 2017;11:1401-12.
- Dasí MJ, Rojo E. Continuidad de los cuidados de enfermería: necesidad de coordinación entre niveles. Enferm Nefrol 2000;3(2):27-33.
- Olowe OA, Ross AJ. Knowledge, adherence and control among patients with hypertension attending a peri-urban primary health care clinic, KwaZulu-Natal. African Journal of Primary Health Care and Family Medicine 2017;9(1):1-7.
- Agbor VN, Takah NF, Aminde LN. Prevalence and factors associated with medication adherence among patients with hypertension in Sub-Sahara Africa. Protocol for a systematic review and meta-analysis. BMJ 2018;8(3):1-6.
Referencias
Franklin SS, Thijs L, Asayama K, Li Y, Hansen TW, Boggia J et al. The Cardiovascular Risk of White-Coat Hypertension. J Am Coll Cardiol 2016;68 (19):2033-43.
Robles NR. Importancia clínica de la hipertensión de bata blanca. Nefrología 2004;24(1):17-8.
Abolbashari M. White Coat Hypertension and Cardiovascular Diseases: Innocent or Guilty. Current Cardiology Report 2018;20(4):25.
Watanabe A, Hirashiki N, Murohara Y, Watanabe N, Kano N, Mori H et al. Abnormal Circadian Blood Pressure Profile as a Prognostic Marker in Patients with Nonischemic Dilated Cardiomyopathy. Cardiology 2017;136:1-9.
De La Sierra A, Gorostidi M, Banegas JR, Segura J, De La Cruz JJ, Ruilope LM. Nocturnal hypertension or nondipping: Which is better associated with the cardiovascular risk profile? Am J Hypertens 2014; 27(5):680-7.
Doménech CM, Sobrino J. Hipertensión nocturna. Hipertensión y Riesgo Vascular 2011;28(4):143-8.
Hansen TW, Li Y, Boggia J, Thijs L, Richart T, Staessen JA. Predictive role of the nighttime blood pressure. Hypertension 2011;57(1):3-10.
Ayala DE, Domínguez M, Otero A, Ríos MT, Gomara SM, Moya A et al. Morning surge and sleep-time blood pressure as prognostic markers of cardiovascular risk: the hygia project. J Hypertens 2015;33 (1).
Mediavilla JD, Fernández C, Arroyo A, Jiménez J. Estudio del patrón circadiano de la presión arterial en pacientes hipertensos. An Med Interna 2007; 24(2):61-6.
Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018;71:127-248.
Egan BM, Li J, Hutchison FN, Ferdinand KC. Hypertension in the United States, 1999 to 2012: progress toward Healthy People 2020 goals. Circulation 2014;130:1692-9.
Sousa F, Neves J, Ferreira R, Polonia J, Bastos JM. In hypertension the change from a non-dipper to a dipper pattern is associated with a better cardiovascular prognosis than the persistence within the non-dipper pattern. J Hypertens 2015;33(1).
Cuspidi C, Giudici V, Negri F, Sala C. Nocturnal nondipping and left ventricular hypertrophy in hypertension: An updated review. Expert Review of Cardiovascular Therapy 2010;8(6):781-92.
Oliveras A, Armario P, Martell-Clarós N, Ruilope LM, De La Sierra A. Urinary albumin excretion is associated with nocturnal systolic blood pressure in resistant hypertensives. Hypertension 2011;57 (3):556-60.
Guerrero L, Fernández L, Andúgar J, Casal MC, Campo C, Segura J et al. Prevalencia de Vasculopatía Periférica Subclínica evaluada mediante el índice tobillo/brazo en pacientes con hipertensión arterial. Enferm Nefrol 2003;6(3):209-10.
Syrseloudis D, Tsioufis C, Andrikou I, Mazaraki A, Thomopoulos C, Mihas C et al. Association of nighttime hypertension with central arterial stiffness and urinary albumin excretion in dipper hypertensive subjects. Hypertens Res 2011;34(1):120-5.
Sekizuka H, Osada N AY. The Factors Affecting the Non-dipper Pattern in Japanese Patients with Severe Obstructive Sleep Apnea. Intern Med 2018;57 (11):1553-9.
Mokhlesi B, Hagen EW, Finn LA, Hla KM, Carter JR, Peppard PE. Obstructive sleep apnoea during REM sleep and incident non-dipping of nocturnal blood pressure: A longitudinal analysis of the Wisconsin Sleep Cohort. Thorax 2015;70(11):1062-9.
Kucukdurmaz Z, Karavelioglu Y, Karapinar H, Gul I, Yilmaz A, Yarlioglues M, et al. Hypertensive response to exercise in dipper and non-dipper normotensive diabetics. Clin Exp Hypertens 2014;36(5):275-9.
Yuzbashian E, Asgari G. Adherence to low-sodium dietary approaches to stop hypertension-stail diet may decrease the risk of incident chronic kidney disease among high-risk patients, a secondary prevention in prospective cohort study. Nephrol Dial Transplant 2018;33(7):1159-68.
Song S, Kim J. Gender differences in the association between dietary pattern and the incidence of hypertension in middle-age and older adults. Nutrients 2018;10(2):252.
Coll B, Betriu A, Feinstein SB, Valdivielso JM, Zamorano JL, Fernández E. Papel de la ecografía carotídea en la reclasificación del riesgo cardiovascular de sujetos de riesgo bajo-intermedio. Rev Esp Cardiol 2013;66(12):929-34.
Arribas Cobo P, Fernández Fuentes S, Guimerá Ferrer-Sama MA, Herrera Martín E, Martínez Aranda MA. Los efectos de una intervención educativa sobre la ingesta de sal para disminuir la sobrehidratación y la hipertensión arterial en pacientes con hemodiálisis. Enferm Nefrol 2013;16(3):87-8.
Jones NRV, Forohui NG, Khaw KT, Whareham NJ, Monsivais P. Accordance to the dietary approaches to stop hypertension diet pattern and cardiovascular disease in a British, population-base cohort. Eur J Epidemiol 2018;357:1794.
Haidari A, Moeini N, Khosravi A. The impact of peer support programme of adherence to the treatment regimen in patients with hypertension. A randomized clinical trial study. Iranian Journal of Nursing Mildwifery Research 2017;22(6):427-30.
Abel WM, Joyner JS, Cornelius JB, Greer DB. Self-care management strategies use by black women who self-report consistent adherence to antihypertensive medication. Patient Preference and Adherence 2017;11:1401-12.
Dasí MJ, Rojo E. Continuidad de los cuidados de enfermería: necesidad de coordinación entre niveles. Enferm Nefrol 2000;3(2):27-33.
Olowe OA, Ross AJ. Knowledge, adherence and control among patients with hypertension attending a peri-urban primary health care clinic, KwaZulu-Natal. African Journal of Primary Health Care and Family Medicine 2017;9(1):1-7.
Agbor VN, Takah NF, Aminde LN. Prevalence and factors associated with medication adherence among patients with hypertension in Sub-Sahara Africa. Protocol for a systematic review and meta-analysis. BMJ 2018;8(3):1-6.