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29. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Hochdruckliga e. V. DHL ® - Deutsche Hypertonie Gesellschaft Deutsches Kompetenzzentrum Bluthochdruck

23. bis 25.11.2005, Berlin

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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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  • S. Lüders - Medizinische Klinik Cloppenberug (Cloppenburg, D)
  • C. Lübcke - St. Josefs-Hospital
  • A. Kulschewski - St. Josefs-Hospital
  • S. Lüders - St. Josefs-Hospital
  • F. Hammersen - St. Josefs-Hospital
  • K. Plate - INFO-GmbH-Institute for Hypertension and Cardiovascular Research
  • M. Schnieders - INFO-GmbH-Institute for Hypertension and Cardiovascular Research
  • J. Berger - University of Hamburg, Eppendorf (Hamburg, D)
  • W. Zidek - Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (Berlin, D)
  • P. Dominiak - University of Lübeck (Lübeck, D)

Hypertonie 2005. 29. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Berlin, 23.-25.11.2005. Düsseldorf, Köln: German Medical Science; 2006. Doc05hochP187

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hoch2005/05hoch187.shtml

Published: August 8, 2006

© 2006 Lüders et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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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.