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    Ambulatory daytime and nighttime heart rate is significantly higher in nondipper hypertensive patients
    (Yeditepe Üniversitesi, 2008) Aparcı, Mustafa; Kardeşoğlu, Ejder; Yiğiner, Ömer; Işılak, Zafer; Uçak, Alper; Uz, Ömer; Demirbolat, Cem; Önem, Yalçın; Cebeci, Bekir Sıtkı
    Objectives Nondipping status; probably a result of sympathetic hyperacitivity; is clinically associated with poor prognosis. In this study we aimed to evaluate the variation of daytime and nighttime heart rate among dipper and nondipper patients probably due to sympathetic hyperactivity. Material and Method 116 patients were enrolled and performed 24 hour ambulatory blood pressure monitoring. 24-hour daytime and nighttime systolic and diastolic blood pressures and heart rates were compared between the dipper and non dipper hypertensive patients. Statistical analysis was performed by Independent Samples t test using SPSS 11.0 for Windows. Results Daytime heart rates were higher in nondipper patients than dipper patients (78,3±9 vs 75,2±9, p=0.1>0.05), but the difference was not statistically significant. Also nighttime heart rates were significantly higher in non dipper patients (65,9±8,7 vs 61,7±7,8, p=0.02<0.05). Nighttime heart rate dipping is significantly lower in nondipper patients (%14.2±6.1 vs %17.8±5.9 p<0.05). Conclusion Increased heart rates of daytime and nighttime period in nondipper patients are clinical finding of sympathetic hyperactivity which was accounted for nondipping. Since nondipping status is closely associated increased risk for cardiovascular events, effective treatment of nondipper patients and modifications in drug therapy may reduce cardiovascular morbidity and mortality.
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    Blood pressure control and dipping status in overweighed and obese hypertensive
    (Yeditepe Üniversitesi, 2008) Aparcı, Mustafa; Kardeşoğlu, Ejder; Yiğiner, Ömer; Işılak, Zafer; Arslan, Zekeriya; Uz, Ömer; Özmen, Namık; Demirbolat, Cem; Cebeci, Bekir Sıtkı
    Objectives: Uncontrolled blood pressure and nondipping status are closely associated with increased cardiovascular risk. In this study we aimed to evaluate blood pressure control and dipping status in overweighed and obese hypertensive patients. Material and method: Seventy two hypertensive patients (57.4±11.9; 21 male, 51 female) were enrolled. Patients were grouped as with BMI <25 kg/m2 and ?25 kg/m2. Patients with diabetes and coronary artery disease were excluded. All of the patients were performed 24-hour ambulatory blood pressure monitoring. Averages of 24-hour, daytime and nighttime systolic, and diastolic blood pressures were calculated. Dipping feature was determined by the >10% decrease of blood pressures in the nighttime measurements compared to daytime measurements. Statistical analyses were done by Mann Whitney U test and Chi Square test using SPSS 11.0. Results: 24 hour daytime and nighttime SBPs were significantly higher in overweighed and obese patients with the BMI ?25 kg/m2 compared to patients with BMI <25 kg/m2 (p<0.05). Also DBPs were higher in the same group but not statistically significant (p>0.05). Distribution of dipping and nondipping was not different between groups, however nondipping status was increased in both of the groups. Conclusions: Targets of optimal blood pressure in overweighed and obese hypertensive patients could not be achieved. Thus hypertensive patients with BMI ?25 kg/m2 are at risk for cerebrovascular and cardiovascular events due to higher daytime and nighttime blood pressure. Non dipping status is also higher in both groups. Blood pressures should be closely monitored and if necessary, combination therapy should be planned to achieve blood pressure targets and to overcome the nondipping status.