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Type: Artigo de periódico
Title: Non-dipping pattern relates to endothelial dysfunction in patients with uncontrolled resistant hypertension
Author: Quinaglia, T
Martins, LC
Figueiredo, VN
Santos, RC
Yugar-Toledo, JC
Martin, JFV
Demacq, C
Pimenta, E
Calhoun, DA
Moreno, H
Abstract: Resistant hypertension (RHTN) includes both patients whose blood pressure (BP) is uncontrolled on three or more medications (uncontrolled RHTN (UCRH)) and patients whose BP is controlled with use of four or more drugs (controlled RHTN (CRH)). It is unknown whether endothelial function and nocturnal drop demonstrate a similar pattern in patients with CRH and UCRH. We examined circadian BP patterns and vascular function in these patients. In all, 40 CRH and 26 UCRH patients, and 25 normotensives underwent biochemical testing, ambulatory BP monitoring, determination of brachial artery responses to endothelial-dependent (flow-mediated; dilation (FMD)) and independent (nitroglycerin mediated) stimuli. The nighttime drop in systolic BP (SBP) and diastolic BP (DBP) was less pronounced in UCRH than in CRH (SBP, 1.9 +/- 1.6 versus 4.9 +/- 1.7%; DBP, 7.5 +/- 1.8 versus 10.9 +/- 1.8%, UCRH and CRH, respectively; P<0.05). FMD was greater in control group compared with RHTN patients. Patients with UCRH had significantly impaired FMD compared with CRH (5.9 +/- 2.3% versus 7.1 +/- 5.1%; P<0.0001). Therefore, UCRH patients have less nocturnal dipping and a more impaired endothelial response compared with CRH patients. These findings suggest that important differences among patients with RHTN may allow identify subgroups with increased cardiovascular risk. Journal of Human Hypertension (2011) 25, 656-664; doi:10.1038/jhh.2011.43; published online 5 May 2011
Subject: resistant hypertension
refractory hypertension
endothelial dysfunction
nitric oxide
nocturnal dipping
Country: Inglaterra
Editor: Nature Publishing Group
Citation: Journal Of Human Hypertension. Nature Publishing Group, v. 25, n. 11, n. 656, n. 664, 2011.
Rights: fechado
Identifier DOI: 10.1038/jhh.2011.43
Date Issue: 2011
Appears in Collections:Unicamp - Artigos e Outros Documentos

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