Article
Is ambulatory pulse pressure elevated in hypertensive patients with transient myocardial ischemia by 24-h Cardiotens monitoring?
24-h Cardiotens Monitoring: Ist die Blutdruckamplitude bei Hypertonikern mit transienter Myokardischämie erhöht?
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Published: | November 11, 2004 |
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Outline
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Background
Several studies reported on the prognostic significance of a raised pulse pressure for cardiovascular events.
Design and Methods
In a German multicenter study 1217 patients (62 ± 13 years, 513 women and 704 men) with treated or untreated arterial hypertension were studied with a new ambulatory 24-h blood pressure (ABPM) device evaluated according to the BHS protocol (Cardiotens, Meditech).
This device allows simultaneous ST-segment analysis with extra blood pressure recordings triggered by the episodes of ST-segment depression.
Results
ST-segment depression (>1mm and >60 sec.) could be demonstrated in 245 patients (20,1%). In 90.3% of the patients with events, transient ischemias were silent. Average 24-h ABPM values for systolic/diastolic blood pressure and heart rate were 135±17/76±11 mmHg, 72±11 beats/min, in patients with ST events and 131±16/74±10 mmHg, 71±11 beats/min, in patients without events (p<0.0003 for systolic blood pressure; n.s. for diastolic blood pressure and heart rate).
The mean ambulatory pulse pressure values were significantly higher in patients with ST events (table). Both in patients with and without events no significant dip between awake and asleep pulse pressures could be observed despite a normal day-night dip of systolic and diastolic blood pressure.
Conclusion
Hypertensive patients with ST-events show higher mean pulse pressure values as compared to patients without events. Ambulatory pulse pressure was sleep-independent and elevation of pulse pressure >60 mmHg probably represents stiffening of large arteries and thus is associated with higher cardiovascular risk.
Mean ambulatory pulse pressure: [Tab. 1]