medigraphic.com
ISSN 1561-2937 (Impreso)

2016, Número 1

<< Anterior Siguiente >>

Rev Cubana Cardiol Cir Cardiovasc 2016; 22 (1)


Importancia de variabilidad de la presión arterial

Hernández VD, Díaz LJ, Aguiar PJE, Betancourt I, Estévez ÁN, Flores SA

Idioma: Español
Referencias bibliográficas: 83
Paginas: 55-61
Archivo PDF: 276.07 Kb.


RESUMEN

Se realizó una revisión actualizada sobre ritmo circadiano y patrones de variabilidad de la presión arterial (PA), factores involucrados y repercusión. Entre los cambios de la presión arterial definidos que inciden en la variabilidad se describe la marea hipertensiva matutina, caracterizada por mayor presión y variabilidad de la misma en las primeras horas de la mañana que en el resto del día, la hipertensión de bata blanca o de consultorio, que es aquella que ocurre en sujetos normotensos en medios habituales y que en un entorno médico presentan cifras de hipertensión y los cambios del patrón durante el reposo nocturno que por convención se considera normal (dipper) cuando la caída nocturna es mayor de 10% y menor de 20%.
Se describen 3 patrones anormales de variaciones de la presión arterial durante el sueño: non dipper, dipper reverso o raiser y dipper extremo o acentuado. Se describen los efectos de la variabilidad sobre órganos diana y su valor pronóstico. Se concluye que los efectos adversos de la hipertensión arterial (HTA) sobre el sistema cardiovascular son reflejos y están determinados, no solo por el grado de elevación de la presión arterial, sino por la magnitud de la variabilidad de la misma en el período de 24 horas.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Mc-Nab P, Jalil J. Valor pronóstico de la monitoria ambulatoria de la presión arterial en pacientes hipertensos: Observaciones en la lite-ratura. Rev Med Chile 2005; 133:89-95.

  2. Chávez Domínguez R, de Micheli A. Epistemological focus on sphymomanometry. Rev Invest Clin 2002; 54:84-91.

  3. Mancia G, Grassi G. Mechanisms and Clinical Implications of Blood Pressure Variability. 2nd Virtual Congress of Cardiology Ar-gentine Federation of Cardiology.

  4. Mancia G, Ferrari A, Gregorini L, Parati G, Pomidossi G, Bertinieri G, Grassi G, Di Rienzo M, Pedotti A, Zanchetti A. Blood pressure and heart rate variability in normotensive and hypertensive human beings. Circ Res 1983; 53:96-104.

  5. Di Rienzo M, Grassi G, Pedotti A, Mancia G. Relationship of 24-hour average blood pressure. Hypertension. 1983; 5:264-69.

  6. Mancia G, Parati G, Pomidossi G, Casadei R, Di Rienzo M, Zan-chetti A. Arterial baroreflexes and blood pressure and heart rate va-riability in humans. Hypertension 1986; 8:147-53.

  7. Parati G, Staessen JA. Day-night blood pressure variations: mechan-isms, reproducibility and clinical relevance. J Hypertens 2007; 25:2377-80.

  8. Hernández del Rey R, Martin-Baranera M, Sobrino J, Gorostidi M, Vinyoles E, Sierra C, et al, on behalf of the Spanish Society of Hypertension Ambulatory Blood Pressure Monitoring Registry in-vestigators. Reproducibility of the circadian blood pressure pattern in 24-h versus 48-h recordings: the Spanish Ambulatory Blood Pressure Monitoring Registry. J Hypertens 2007; 25:2406-12.

  9. Mancia G, Parati G, Omboni S, Ulian L, Zanchetti A. Ambulatory blood pressure monitoring. Clin Expert Hypertens 1999; 21:703-15.

  10. White W. Ambulatory Blood-Pressure Monitoring in Clinical Practice. N Engl J Med 2003 348; 24: 2377-78.

  11. O’Brien E, Coats A, Owens P, Petrie J, Padfield PL, Littler WA et al. Use and interpretation of ambulatory blood pressure monitoring: recommendations of the British Hypertension Society. BMJ 2000; 320: 1128-34.

  12. Sander D, Klingelhofer J. Diurnal systolic blood pressure variability is the strongest predictor of early carotid atherosclerosis. Neurology 1996; 47:500-507.

  13. Mancia G, Parati G, Henning M, Flatau B, Omboni S, Glavina F, Costa B, Scherz R, Bond G, Zanchetti A, On Behalf of the ELSA investigators. Relation between blood pressure and carotid artery damage in hypertension: baseline data from The European Lacidi-pine Study on Atherosclerosis (ELSA) J Hypertens. 2001; 19:1981-89.

  14. Sander D, Kukla C, Klingerhofer J, Winbeck K, Conrad B. Rela-tionship between circadian blood pressure patterns and progression of early carotid atherosclerosis a 3 year follow up study. Circulation 2000; 102:1536-41.

  15. Mancia G, Parati G, Castiglioni P, Tordi R, Tortorici E, Glavina F, Di Rienzo M. Daily life blood pressure changes are stepper in hypertensive than in normotensive subjects. Hypertension 2003; 42:277-82.

  16. Yamamoto Y, Akiguchi I, Oiwa K, Hayashi M, Kasai T, Ozasa K. Twenty-four-Hour Blood Pressure and MRI as Predictive Factors for Different Outcomes in Patients With Lacunar Infarct. Stroke 2002; 33; 297-305.

  17. Grin JM, McCabe EJ, White WB. Management of hypertension after ambulatory blood pressure monitoring. Ann Intern Med 1993; 118:833-7.

  18. Prat H, Valdez G, Roman O, Zárate LH, Jalil J. recommendations for the use of ambulatory blood pressure monitoring. Consensus document of the Chilean Hypertension Society. Rev Med Chile 1999; 127: 1269-73.

  19. Verdecchia P, Angeli F, Gattobigio R. Clinical Usefulness of Am-bulatory Blood Pressure Monitoring. J Am Soc Nephrol; 2004 15: S30-S33.

  20. Waterhouse J, Drust B, Weinert D, Edwards B, Gregson W, Atkin-son G, Kao S, Aizawa S, Reilly T. The circadian rhythm of core temperature: origin and some implications for exercise performance. Chronobiol Int 2005; 22: 205-23.

  21. Pickering T. Diurnal rhythms and other sources of blood pressure variability in normal and hypertensive subjects. En: Hypertension: Pathophysiology, Diagnosis and Management. Cap 86: 1397-1403. Ed. Laragh and Brenner. Raven Press, Ltd. New York 1990.

  22. Naska A, Oikonomou E, Trichopoulou A, Psaltapouou T, Tricho-poulos D. Siesta in healthy adults and coronary mortality in the gen-eral population. Arch Intern Med 2007; 167: 296-301.

  23. Carrington MJ, Barbieri R, Colrain IM, Crowley KE, Kim Y, Trinder J. Changes in cardiovascular function during the sleep onset period in young adults. J Appl Physiol 2005; 98: 468-76.

  24. Cymerys M, Miczke A, Bryl W, Kujawska-Luczak M, Bogdanski P, Pupek-Musialik D. Circadian rhythm and variability of blood pres-sure and target organ damage in essential hypertension. Pol Arch Med Wewn. 2002 Jul; 108(1):625-31.

  25. Elliott WJ. Cyclic and circadian variations in cardiovascular events. Am J Hypertens 2001; 14: 291S-295S.

  26. Zaregarizi M, Edwards B, George K, Harrison Y, Jones H, Atkinson G. Acute changes in cardiovascular function during the onset period of daytime sleep: comparison to lying awake and standing. J Appl Physiol 2007; 103: 1332-38.

  27. Biaggioni I. Circadian Clocks, Autonomic Rhythms, and Blood Pressure Dipping. Hypertension. 2008; 52:797.

  28. Vrijkotte T G. M, van Doornen L J. P, de Geus E J. C. Effects of Work Stress on Ambulatory Blood Pressure, Heart Rate, and Heart. Hypertension 2000; 35; 880-86. Disponible en: http:// hyper. Aha journals. org/cgi/ content/ full/35/ 4/880

  29. Light KL, Girdler SS, Sherwood A, Bragdon EE, Brownley KA, West SG, Hinderliter AL. High stress responsivity predicts later blood pressure only in combination with positive family history and high life stress. Hypertension. 1999; 33:1458-64.

  30. Kulah E, Dursun A, Aktunc E, Acikgoz S, Aydin M, Can M, Dur-sun A. Effects of angiotensin-converting enzyme gene polymor-phism and serum vitamin D levels on ambulatory blood pressure measurement and left ventricular mass in Turkish hypertensive pop-ulation. Blood Press Monit. 2007 Aug.; 12(4):207-13.

  31. Qiu YG, Yao XY, Tao QM, Zheng P, Chen JZ, Zhu JH, Zhang FR, Zheng LR, Zhao LL. Profile on circadian blood pressure and the in-fluencing factors in essential hypertensive patients after treatment. Zhonghua Liu Xing Bing Xue Za Zhi 2004 Aug.; 25(8):710-4.

  32. Osanai T, Okuguchi T, Kamada T, Fujiwara N, Kosugi T, Saitoh G, Katoh T, Nakano T, Takahashi K, Guan W, Okumura K. Salt-induced exacerbation of morning surge in blood pressure in patients with essential hypertension. J Hum Hypertens. 2000 Jan; 14(1):57-64.

  33. Lantelme P, Khettab F, Custaud MA, Rial M.O, Joanny C, Gharib C, Milon H. Spontaneous baroreflex sensitivity: toward an ideal in-dex of cardiovascular risk in hypertension? J Hypertens. 2002 May; 20(5):935-44. Comment in: J Hypertens. 2002 May; 20(5):829-31.

  34. Hesse C, Charkoudian N, Liu Z, Joyner M J, Eisenach J H. Baroref-lex Sensitivity Inversely Correlates With Ambulatory Blood Pres-sure in Healthy Normotensive Humans. Hypertension 2007: 50; 41-46.

  35. Parati G, Pomidossi G, Albini F, Malaspina D, Mancia G. Relation-ship of 24-hour mean and variability to severity of target organ damage in hypertension. J Hypertens 1987; 5:93-98.

  36. Grassi G, Cattaneo BM, Seravalle G, Lanfranchi A, Mancia G. Baroreflex control of sympathetic nerve activity in essential and secondary hypertension. Hypertension 1998; 31:68-72.

  37. Dodt C, Breckling U, Derad I, Fehm HL, Born J. Plasma epineph-rine and norepinephrine concentrations of healthy humans asso-ciated with nighttimes sleep and morning arousal. Hypertension 1997; 30:71-76.

  38. Sega R, Cesana G, Bombelli M et al. Seasonal variations in home and ambulatory blood pressure in the PAMELA population. J Hypertens 1998; 16:1585-92.

  39. Khaar RS, Swales JD, Dore C, et al. Effect of aging on the prognos-tic significance of ambulatory systolic, diastolic, and pulse pressure in essential hypertension. Circulation. 2001; 104:783-89.

  40. Rönnback M, Fagerudd J, Forsblom C, Pettersson-Fernholm K, Reunanen A, Per-Henrik Groop and on behalf of the Finnish Di-abetic Nephropathy Study Group. Altered Age-Related Blood Pres-sure Pattern in Type 1 Diabetes. Circulation 2004; 110:1076-82.

  41. Mancia G, Parati G, Di Rienzo M, Zanchetti A. Blood pressure variability. In: Zanchetti A, Mancia G, eds. Handbook of hyperten-sion, vol 17: Pathophysiology of hypertension. Amsterdam: Elsevier Science 1997; 117-69.

  42. Feng A, Yin W, Young M, Lin M. Association between 894G>T polymorphism in the Endothelial Nitric Oxide Synthase Gene and Circadian Variation of Blood Pressure in Patients with Essential Hypertension. Acta Cardiológica Sinica 2005; 21(3):137-45.

  43. White WB Cardiovascular risk and therapeutic intervention for the early morning surge in blood pressure and heart rate. Blood Press Monit 2001; 6:63-72.

  44. Kario K, Pickering TG, Umeda Y, Hoshide S, Hoshide Y, Morinari M, Murata M, Kuroda T, Schwartz JE, Shimada K. Morning surge in blood pressure as a predictor of silent and clinical cerebro vascu-lar disease in elderly hypertensive: A prospective study. Ccircula-tion 2003; 107:1401-06.

  45. Kario K, Pickering TG, Hoshide S, Eguchi K, Ishikawa J, Morinari M, Hoshide Y, Shimada K. Morning blood pressure surge and hypertensive cerebro vascular disease: role of the alpha adrenergic sympathetic nervous system. Am J Hypertens. 2004 Aug; 17(8):668-75.

  46. Kario K. Morning Surge and Variability in Blood Pressure. Hyper-tension. 2005; 45:485.

  47. Polónia J, Amado P, Barbosa L, Nazaré J, Silva JA, Bertoquini S, Martins L, Carmona J. Morning rise, morning surge and daytime variability of blood pressure and cardiovascular target organ dam-age. A cross-sectional study in 743 subjects. Rev Port Cardiol. 2005 Jan; 24(1):65-78.

  48. Gami A, Howard E, Olson E, Somers V. Day–Night Pattern of Sudden Death in Obstructive Sleep Apnea. N Engl J Med 2005; 352:1206-14.

  49. Willich SN, Goldberg RJ, Maclure M, et al. Increased onset of sudden cardiac death in the first three hours of awakening. Am J Cardiol. 1992; 70: 65-68.

  50. Muller JE, Tofler GH, Stone PH. Circadian variation and triggers of onset of acute cardiovascular disease. Circulation 1989; 79:733-43.

  51. O’Brian, Sheridan J, O’Malley K. Dippers and non-dippers. Lancet 1988; 13:397.

  52. Aydin M, Ozeren A, Bilge M, Dursun A, Cam F, Elbey M. Effects of dipper and non-dipper status of essential hypertension on left atrial mechanical functions. International Journal of Cardiology 2003; 96(3): 419-24.

  53. Erdogan D, Gullu H, Caliskan M, Yildirim I. Ulus T, Bilgi M, Mudurrisoglu H. Coronary flow reserve in dipper andnon-dipper hypertensive patients. Blood Pressure. 2005; 14: 345-52.

  54. Kario K, Pickering TG, Matsuo T, Hoshide S, Schwartz JE, Shima-da K. Stroke prognosis and abnormal nocturnal blood pressure falls in older hypertensive. Hhypertension 2001; 38:852-57.

  55. Cuspidi C, Meani S, Salerno M, Valerio C, Fusi V, Severgnini B, Lonati L, Magrini F, Zanchetti A. Reproducibility of nocturnal blood pressure fall in early phases of untreated essential hyperten-sion: a prospective observational study. Journal of Human Hyper-tension 2004; 18: 503-09.

  56. Ardashev VN, Fursov AN, Konev AV, Kulichik TD, Chubarova OG, Krivozubov EF. Prediction of brain infarction in hypertensive patients. Klin Med (Mosk) 2004; 82(4): 40-3.

  57. Timio M, Venanzi S, Lolli S, Lippi G, Verdura C, Monarca C, Guarrini E. Non Dipper hypertensive patients and progressive renal insufficiency a 3-year longitudinal study. Clin Nephrol 1995; 43:382-87.

  58. Cuspidi C, Michev I, Meani S, Valerio C, Bertazzoli G, Magrini F, Zanchetti A. Non-dipper treated hypertensive patients do not have increased cardiac structural alterations. Cardiovasc Ultrasound. 2003; 1:1.

  59. Cuspidi C, Meani S, Salerno M, Valerio C, Fusi V, Severgnini B, Lonati L, Magrini F, Zanchetti A. Cardiovascular target organ dam-age in essential hypertensive with or without reproducible nocturnal fall in blood pressure. J Hypertens 2004; 22 (2): 273-80.

  60. Birkenhäger AM, van den Meiracker AH. Causes and consequences of a non-dipping blood pressure profile. Neth J Med 2007; 65(4): 127-31.

  61. Badorff C, Dimmeler S. Regulation of the Cytoskeleton in Conges-tive Heart Failure by Nitric Oxide. Circulation. 2003; 107:1348.

  62. De Belder AJ, Radomski MW, Why HJ, et al. Nitric oxide synthase activities in human myocardium. Lancet. 1993; 341: 84-5.

  63. Pickering TG, Coats A, Mallion JM, Mancia G, Verdecchia P. Task Force V: White coat hypertension. Blood Pressure Monitoring 1999; 4:333-41.

  64. Verdecchia P, Staessen JA, White WB, Imal Y, O’Brien E.T. Prop-erly defining white coat hypertension. European Heart J 2002; 23; 106-9.

  65. Silveira A, Mesquita A, Maldonado J, Silva JA, Polonia J. White coat effect in treated and untreated patients with high office blood pressure. Relationship with pulse wave velocity and left ventricular mass index. Rev Port Cardiol. 2002; 21(5):517-30.

  66. Grassi G. Role of the sympathetic nervous system in human hyper-tension. J Hypertens 1998; 16:1979-87.

  67. Grassi G, Turri C, Vailati S, Dell'Oro R, Mancia G. Muscle and skin sympathetic nerve traffic during the "white coat" effect. Circulation 1999; 100:222-25.

  68. Mancia G. Bjorn Folkow Award Lecture. The sympathetic nervous system in hypertension. J Hypertens 1997; 15:1553-65.

  69. Verdecchia P, Schillaci G, Borgioni C, Ciucci A, Porcellati C. White coat hypertension. Lancet 1996; 348:1444-45.

  70. Angeli F, Verdecchia P, Gattobigio R, Sardone M, Reboldi G. White-coat hypertension in adults. Blood Press Monit. 2005; 10(6):301-5.

  71. Verdecchia P, Porcellati C, Schillaci G, et al. Ambulatory blood pressure an independent predictor of prognosis in essential hyper-tension. Hypertension 1994; 24:793-801.

  72. Parati G, Valentín M. Prognostic relevance of blood pressure varia-bility. Hypertension 2006; 47:137.

  73. 73. Fagard RH, Staessen JA, Thijs L et al. Response to antihyper-tensive therapy in older persons with sustained and nonsustained systolic hypertension. Circulation 2000; 102:1139-1144.

  74. Clement et al. Office versus Ambulatory Pressure Study. Prognostic value of ambulatory blood-pressure recordings in patients with treated hypertension. N Engl J Med 2003; 348; 24: 2407–15.

  75. 75. Ezzati M, Oza S, Danaei G, Murray C. Trends and Cardiovas-cular Mortality Effects of State-Level Blood Pressure and Uncon-trolled Hypertension in the United States. Circulation 2008; 117; 905-14.

  76. 76. Grupo de Trabajo para el Tratamiento de la Hipertensión Arterial de la Sociedad Europea de Hipertensión (ESH) y de la So-ciedad Europea de Cardiología (ESC). Guías de práctica clínica para el tratamiento de la hipertensión arterial 2007. Rev Esp. Cardiol. 2007; 60(9):968.e1-e94.

  77. 77. Van Boxtel J, Henskens G, Kroon A, Hofman M, Gronenschild M, Jolles J, de Leeuw P W. Ambulatory blood pressure, asympto-matic cerebro vascular damage and cognitive function in essential hypertension. Journal of Human Hypertension 2006; 20: 5-13.

  78. 78. Toprak A, Koc M, Tezcan H, Ozener I C, Oktay A and Akoglu E. Night-time blood pressure load is associated with higher left ven-tricular mass index in renal transplant recipients. Journal of Human Hypertension 2003; 17: 239-44.

  79. Vagaonescu TD, Saadia D, Tuhrim S, Phillips RA, Kaufmann H. Hypertensive cardiovascular damage in patients with primary auto-nomic failure. Lancet. 2000 Feb 26; 355(9205):725-6.

  80. Cuspid C, Mean S, Valerio C, Esposito A, Sala C, Maisaidi M, Zanchetti A, Mancia G. Ambulatory blood pressure, target organ damage and aortic root size in never-treated essential hypertensive patients. Journal of Human Hypertension 2007; 21: 531-38.

  81. Mancia G, Zanchetti A, Agabiti-Rosei E et al, for the SAMPLE Study Group. Ambulatory blood pressure is superior to clinic blood pressure in predicting treatment-induced regression of left ventricu-lar hypertrophy: the SAMPLE Study. Circulation 1997; 95:1464-70.

  82. Leary S D, Ness A R, Smith G D, Mattocks C, Deere K, Blair S N, Riddoch C. Physical Activity and Blood Pressure in Childhood Findings From a Population-Based Study. Hypertension 2008; 51; 92-8.

  83. Mulè G, Nardi E, Andronico G, Cottone S, Federico MR, Piazza G, Volpe V, Ferrara D, Cerasola G. Pulsatile and steady 24-h blood pressure components as determinants of left ventricular mass in young and middle-aged essential hypertensive. J Hum Hypertens. 2003 Apr: 17(4):231-8.




2020     |     www.medigraphic.com