Evaluation of tolerance to ambulatory blood pressure monitoring: Analysis of dipping profile in a large cohort of hypertensive patients
Ambulatory blood pressure monitoring (ABPM) is a helpful tool to comprehensively identify and diagnose arterial hypertension. Moreover, it allows to better identify alterations in the circadian BP profile, as the nocturnal "nondipping" status, characterized by a lack of the physiological 1...
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creator | Iannucci, Gino Petramala, Luigi La Torre, Giuseppe Barbaro, Barbara Balsano, Clara Curatulo, Pietro Giacomo Amadei, Francesco Paroli, Marino Concistrè, Antonio Letizia, Claudio |
description | Ambulatory blood pressure monitoring (ABPM) is a helpful tool to comprehensively identify and diagnose arterial hypertension. Moreover, it allows to better identify alterations in the circadian BP profile, as the nocturnal "nondipping" status, characterized by a lack of the physiological 10% night BP reduction and associated with a greater risk of target organ damage. However, ABPM has some limitations such as restricted availability, discomfort, particularly at night, cost implications, and reproducibility.Aim of the study was evaluate if the "nondipping" phenomenon may be related to low degree of tolerance to ABPM. Additionally, to determine whether self-reported events of sleep disorders and nighttime urinations may affect the "nondipping" status.From January 2013 to December 2015, we consecutively evaluated 1046 patients with arterial hypertension, performing ABPM, considering a tolerance index calculated on the basis of the patients' responses to a questionnaire.Thirty-eight out of 1046 patients showed complete lack of tolerance to the instrument during the day, whilst 126 during the night. There were no statistically significant differences in daytime and nighttime values of tolerance to the instrument between "dippers" and "nondippers," between "extreme-dippers" and the remaining patients or between "reverse-dippers" and the remaining patients. There were no statistically significant differences in the number of nocturnal awakenings between the groups. However, we found that the number of awakenings followed by urination was higher in "nondipping" patients and in "reverse-dipping" patients compared to the other groups.We found that the poor tolerance to the instrument does not seem to influence the BP "dipping" phenomenon among hypertensive individuals. Moreover, we think that in the evaluation of the ABPM data, factors, such as nocturnal urination and sleep disorders, need to be carefully taken into account, since may lead to a higher incidence of "nondipping" pattern. |
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Moreover, it allows to better identify alterations in the circadian BP profile, as the nocturnal "nondipping" status, characterized by a lack of the physiological 10% night BP reduction and associated with a greater risk of target organ damage. However, ABPM has some limitations such as restricted availability, discomfort, particularly at night, cost implications, and reproducibility.Aim of the study was evaluate if the "nondipping" phenomenon may be related to low degree of tolerance to ABPM. Additionally, to determine whether self-reported events of sleep disorders and nighttime urinations may affect the "nondipping" status.From January 2013 to December 2015, we consecutively evaluated 1046 patients with arterial hypertension, performing ABPM, considering a tolerance index calculated on the basis of the patients' responses to a questionnaire.Thirty-eight out of 1046 patients showed complete lack of tolerance to the instrument during the day, whilst 126 during the night. There were no statistically significant differences in daytime and nighttime values of tolerance to the instrument between "dippers" and "nondippers," between "extreme-dippers" and the remaining patients or between "reverse-dippers" and the remaining patients. There were no statistically significant differences in the number of nocturnal awakenings between the groups. However, we found that the number of awakenings followed by urination was higher in "nondipping" patients and in "reverse-dipping" patients compared to the other groups.We found that the poor tolerance to the instrument does not seem to influence the BP "dipping" phenomenon among hypertensive individuals. Moreover, we think that in the evaluation of the ABPM data, factors, such as nocturnal urination and sleep disorders, need to be carefully taken into account, since may lead to a higher incidence of "nondipping" pattern.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000009162</identifier><identifier>PMID: 29390325</identifier><language>eng</language><publisher>United States: The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Blood Pressure Monitoring, Ambulatory ; Female ; Humans ; Hypertension - physiopathology ; Male ; Middle Aged ; Observational Study ; Patient Acceptance of Health Care ; Surveys and Questionnaires</subject><ispartof>Medicine (Baltimore), 2017-12, Vol.96 (50), p.e9162-e9162</ispartof><rights>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3555-3ad63e7f856aab12aa0703aaf9fa8177a0975b4c9f17b7093e826653353fd1103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815737/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815737/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29390325$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iannucci, Gino</creatorcontrib><creatorcontrib>Petramala, Luigi</creatorcontrib><creatorcontrib>La Torre, Giuseppe</creatorcontrib><creatorcontrib>Barbaro, Barbara</creatorcontrib><creatorcontrib>Balsano, Clara</creatorcontrib><creatorcontrib>Curatulo, Pietro Giacomo</creatorcontrib><creatorcontrib>Amadei, Francesco</creatorcontrib><creatorcontrib>Paroli, Marino</creatorcontrib><creatorcontrib>Concistrè, Antonio</creatorcontrib><creatorcontrib>Letizia, Claudio</creatorcontrib><title>Evaluation of tolerance to ambulatory blood pressure monitoring: Analysis of dipping profile in a large cohort of hypertensive patients</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>Ambulatory blood pressure monitoring (ABPM) is a helpful tool to comprehensively identify and diagnose arterial hypertension. Moreover, it allows to better identify alterations in the circadian BP profile, as the nocturnal "nondipping" status, characterized by a lack of the physiological 10% night BP reduction and associated with a greater risk of target organ damage. However, ABPM has some limitations such as restricted availability, discomfort, particularly at night, cost implications, and reproducibility.Aim of the study was evaluate if the "nondipping" phenomenon may be related to low degree of tolerance to ABPM. Additionally, to determine whether self-reported events of sleep disorders and nighttime urinations may affect the "nondipping" status.From January 2013 to December 2015, we consecutively evaluated 1046 patients with arterial hypertension, performing ABPM, considering a tolerance index calculated on the basis of the patients' responses to a questionnaire.Thirty-eight out of 1046 patients showed complete lack of tolerance to the instrument during the day, whilst 126 during the night. There were no statistically significant differences in daytime and nighttime values of tolerance to the instrument between "dippers" and "nondippers," between "extreme-dippers" and the remaining patients or between "reverse-dippers" and the remaining patients. There were no statistically significant differences in the number of nocturnal awakenings between the groups. However, we found that the number of awakenings followed by urination was higher in "nondipping" patients and in "reverse-dipping" patients compared to the other groups.We found that the poor tolerance to the instrument does not seem to influence the BP "dipping" phenomenon among hypertensive individuals. Moreover, we think that in the evaluation of the ABPM data, factors, such as nocturnal urination and sleep disorders, need to be carefully taken into account, since may lead to a higher incidence of "nondipping" pattern.</description><subject>Blood Pressure Monitoring, Ambulatory</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Observational Study</subject><subject>Patient Acceptance of Health Care</subject><subject>Surveys and Questionnaires</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUctu1DAUtRCIDoUvQEJesknxI47HLJCqtjykVmxgbd0kNxODxw52MtV8QX8bD1Oqgje2js_j6h5CXnN2xpnR724uz9ijY3gjnpAVV7KplGnqp2TFmFCVNro-IS9y_sEYl1rUz8mJMNIwKdSK3F3twC8wuxhoHOgcPSYIHZYXhW27eJhj2tPWx9jTKWHOS0K6jcEV3IXNe3oewO-zywd576apgIUYB-eRukCBekgbpF0cY5oPpHE_YZoxZLdDOpVoDHN-SZ4N4DO-ur9PyfePV98uPlfXXz99uTi_rjqplKok9I1EPaxVA9ByAcA0kwCDGWDNtYayGNXWnRm4bjUzEteiaZSUSg4950yekg9H32lpt9h3JTuBt1NyW0h7G8HZf3-CG-0m7qxac6WlLgZv7w1S_LVgnu3W5Q69h4BxyZabsltjtOaFKo_ULsWcEw4PMZzZQ4X25tL-X2FRvXk84YPmb2eFUB8Jt9HPmPJPv9xisiOCn8c_fkobUQnGNRdcsaogWsnfKTCqOA</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>Iannucci, Gino</creator><creator>Petramala, Luigi</creator><creator>La Torre, Giuseppe</creator><creator>Barbaro, Barbara</creator><creator>Balsano, Clara</creator><creator>Curatulo, Pietro Giacomo</creator><creator>Amadei, Francesco</creator><creator>Paroli, Marino</creator><creator>Concistrè, Antonio</creator><creator>Letizia, Claudio</creator><general>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</general><general>Wolters Kluwer Health</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20171201</creationdate><title>Evaluation of tolerance to ambulatory blood pressure monitoring: Analysis of dipping profile in a large cohort of hypertensive patients</title><author>Iannucci, Gino ; Petramala, Luigi ; La Torre, Giuseppe ; Barbaro, Barbara ; Balsano, Clara ; Curatulo, Pietro Giacomo ; Amadei, Francesco ; Paroli, Marino ; Concistrè, Antonio ; Letizia, Claudio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3555-3ad63e7f856aab12aa0703aaf9fa8177a0975b4c9f17b7093e826653353fd1103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Blood Pressure Monitoring, Ambulatory</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Observational Study</topic><topic>Patient Acceptance of Health Care</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iannucci, Gino</creatorcontrib><creatorcontrib>Petramala, Luigi</creatorcontrib><creatorcontrib>La Torre, Giuseppe</creatorcontrib><creatorcontrib>Barbaro, Barbara</creatorcontrib><creatorcontrib>Balsano, Clara</creatorcontrib><creatorcontrib>Curatulo, Pietro Giacomo</creatorcontrib><creatorcontrib>Amadei, Francesco</creatorcontrib><creatorcontrib>Paroli, Marino</creatorcontrib><creatorcontrib>Concistrè, Antonio</creatorcontrib><creatorcontrib>Letizia, Claudio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iannucci, Gino</au><au>Petramala, Luigi</au><au>La Torre, Giuseppe</au><au>Barbaro, Barbara</au><au>Balsano, Clara</au><au>Curatulo, Pietro Giacomo</au><au>Amadei, Francesco</au><au>Paroli, Marino</au><au>Concistrè, Antonio</au><au>Letizia, Claudio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of tolerance to ambulatory blood pressure monitoring: Analysis of dipping profile in a large cohort of hypertensive patients</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>96</volume><issue>50</issue><spage>e9162</spage><epage>e9162</epage><pages>e9162-e9162</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>Ambulatory blood pressure monitoring (ABPM) is a helpful tool to comprehensively identify and diagnose arterial hypertension. Moreover, it allows to better identify alterations in the circadian BP profile, as the nocturnal "nondipping" status, characterized by a lack of the physiological 10% night BP reduction and associated with a greater risk of target organ damage. However, ABPM has some limitations such as restricted availability, discomfort, particularly at night, cost implications, and reproducibility.Aim of the study was evaluate if the "nondipping" phenomenon may be related to low degree of tolerance to ABPM. Additionally, to determine whether self-reported events of sleep disorders and nighttime urinations may affect the "nondipping" status.From January 2013 to December 2015, we consecutively evaluated 1046 patients with arterial hypertension, performing ABPM, considering a tolerance index calculated on the basis of the patients' responses to a questionnaire.Thirty-eight out of 1046 patients showed complete lack of tolerance to the instrument during the day, whilst 126 during the night. There were no statistically significant differences in daytime and nighttime values of tolerance to the instrument between "dippers" and "nondippers," between "extreme-dippers" and the remaining patients or between "reverse-dippers" and the remaining patients. There were no statistically significant differences in the number of nocturnal awakenings between the groups. However, we found that the number of awakenings followed by urination was higher in "nondipping" patients and in "reverse-dipping" patients compared to the other groups.We found that the poor tolerance to the instrument does not seem to influence the BP "dipping" phenomenon among hypertensive individuals. Moreover, we think that in the evaluation of the ABPM data, factors, such as nocturnal urination and sleep disorders, need to be carefully taken into account, since may lead to a higher incidence of "nondipping" pattern.</abstract><cop>United States</cop><pub>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>29390325</pmid><doi>10.1097/MD.0000000000009162</doi><oa>free_for_read</oa></addata></record> |
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subjects | Blood Pressure Monitoring, Ambulatory Female Humans Hypertension - physiopathology Male Middle Aged Observational Study Patient Acceptance of Health Care Surveys and Questionnaires |
title | Evaluation of tolerance to ambulatory blood pressure monitoring: Analysis of dipping profile in a large cohort of hypertensive patients |
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