Artikel
Effects of dipping and non-dipping on minimal-mental-status and cerebro/cardiovascular prognosis: subgroup analyses of the MOSES-Study (Morbidity and Mortality After Stroke, Eprosartan Compared With Nitrendipine for Secondary Prevention)
Einfluß von Dipping und Non-Dipping auf Mini Mental Status und cerebro/kardiovaskuläre Prognose: Subgruppenanalyse der MOSES-Studie (Mortalität und Morbidität nach Schlaganfall, Eprosartan und Nitrendipin in der Sekundärprophylaxe)
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Veröffentlicht: | 8. August 2006 |
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Gliederung
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Background: Non-dipping of blood pressure during the night is of great impact on cardiovascular prognoses and may have influence on cognitive function as well. A subgroup analyses of the MOSES-study should reveal the influence of dipping (d) and non-dipping (n-d) in the ABPM at study admission on the primary endpoint and the cognitive function (cf). The primary results of the MOSES study had shown a significant advantage for patients with antihypertensive treatment based on eprosartan compared to nitrendipine.
Methods: 1352 patients -all hypertensives with cerebral events during the last 24 months (proven by cerebral imaging)- were categorized independently of treatment group according dipping or non-dipping in the ABPM at study admission. During follow-up (mean 2.5 years) events of combined primary endpoint (all cause-mortality and all cardiovascular and cerebrovascular events) were evaluated by blinded endpoint comittee. Cognitive function was estimated by using the minimal-mental-status (mms).
Results: In total 461 primary events occurred. Concerning the d and n-d there were primary event rates of 25.2 % for d and 35.9 % for n-d corresponding to a reduction of 29.8 % for d. A worsening of mms during follow-up was observed in 29.8 % of the d and 35.1 % of the n-d corresponding to an increase in loss of cerebral function of 17.8 % for n-d.
Conclusions: Non-dipping of blood pressure in hypertensives with history of cerebrovascular events was associated with a poorer prognosis concerning the cerebro-/cardiovascular risk and total mortality as well as the cognitive function.