Short-term variability and nocturnal decline in ambulatory blood pressure in normotension, white-coat hypertension, masked hypertension and sustained hypertension: A population-based study of older individuals in Spain

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dc.contributor.author Gijón-Conde, Teresa
dc.contributor.author Graciani, Auxiliadora
dc.contributor.author López-García, Esther
dc.contributor.author Guallar-Castillón, Pilar
dc.contributor.author García-Esquinas, Esther
dc.contributor.author Rodríguez-Artalejo, Fernando
dc.contributor.author Banegas, José Ramón
dc.contributor.other UAM. Departamento de Medicina Preventiva y Salud Pública y Microbiología es_ES
dc.date.accessioned 2018-01-29T12:10:43Z
dc.date.available 2018-01-29T12:10:43Z
dc.date.issued 2017-02-09
dc.identifier.citation Hypertension Research 40.6 (2017): 613-619 en_US
dc.identifier.issn 0916-9636 (print) en_US
dc.identifier.issn 1348-4214 (online) en_US
dc.identifier.uri http://hdl.handle.net/10486/681036
dc.description.abstract Blood pressure (BP) variability and nocturnal decline in blood pressure are associated with cardiovascular outcomes. However, little is known about whether these indexes are associated with white-coat and masked hypertension. We performed a cross-sectional analysis of 1047 community-dwelling individuals aged ≥60 years in Spain in 2012. Three observer-measured home BPs and 24-h ambulatory blood pr essure monitoring (ABPM) were performed under standardized conditions. BP variability was defined as BP s.d. and coefficient of variation. Differences in BP variability and nocturnal BP decrease between groups were adjusted for sociodemographic and clinical covariates using generalized linear models. Of the cohort, 21.7% had white-coat hypertension, 7.0% had masked hypertension, 21.4% had sustained hypertension, and 49.9% were normotensive. Twenty-four hour, daytime and night-time systolic BP s.d. and coefficients of variation were significantly higher in subjects with white-coat hypertension than those with normotension (P < 0.05) and were similar to subjects with sustained hypertension. In untreated subjects, 24-h but not daytime or night-time BP variability indexes were significantly higher in subjects with white-coat hypertension than in those with normotension (P < 0.05). Percentage decrease in nocturnal systolic and diastolic BP was greatest in the white-coat hypertension group and lowest in the masked hypertension group in all patients and untreated patients (P < 0.05). Lack of nocturnal decline in systolic blood pressure was observed in 70.2% of subjects with normotension, 57.8% of subjects with white-coat hypertension, 78.1% of subjects with masked hypertension, and 72.2% of subjects with sustained hypertension (P < 0.001). In conclusion, 24-h BP variability was higher in subjects with white-coat hypertension and blunted nocturnal BP decrease was observed more frequently in subjects with masked hypertension. These findings may help to explain the reports of increased cardiovascular risk in patients with white-coat hypertension and poor prognosis in those with masked hypertension, highlighting the importance of ABPM en_US
dc.description.sponsorship Study partially funded by FIS grant PI13/02321 and PI16/01460 (Instituto de Salud Carlos III and FEDER/FSE) and CIBERESP en_US
dc.format.extent 20 pag. es_ES
dc.format.mimetype application/pdf en_US
dc.language.iso eng en_US
dc.publisher Nature Publishing Group en_US
dc.relation.ispartof Hypertension Research en_US
dc.rights © 2017 The Japanese Society of Hypertension All rights reserved en_US
dc.subject.other aged en_US
dc.subject.other blood pressure variability en_US
dc.subject.other masked hypertension en_US
dc.subject.other population studies en_US
dc.subject.other white-coat hypertension en_US
dc.title Short-term variability and nocturnal decline in ambulatory blood pressure in normotension, white-coat hypertension, masked hypertension and sustained hypertension: A population-based study of older individuals in Spain en_US
dc.type article en_US
dc.subject.eciencia Medicina es_ES
dc.date.embargoend 2017-08-09
dc.relation.publisherversion http://doi.org/10.1038/hr.2017.9 es_ES
dc.identifier.doi 10.1038/hr.2017.9 es_ES
dc.identifier.publicationfirstpage 613 es_ES
dc.identifier.publicationissue 6 es_ES
dc.identifier.publicationlastpage 619 es_ES
dc.identifier.publicationvolume 40 es_ES
dc.relation.projectID Gobierno de España. PI13/02321 es_ES
dc.relation.projectID Gobierno de España. PI16/01460 es_ES
dc.type.version info:eu-repo/semantics/acceptedVersion en_US
dc.rights.accessRights openAccess en_US
dc.authorUAM Banegas Banegas, José Ramón (261477)


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