Search

Background: Acute high altitude (HA) exposure results in blood pressure (BP) variations in most subjects. Previous studies have demonstrated that higher BP is potentially correlated with acute mountain sickness (AMS). The BP load may be of clinical significance regarding systemic circulation status.Objectives: This study aimed to examine HA-induced BP changes in patients with AMS compared to those in healthy subjects. Further, we provided clinical information about the relationship between variations in 24-h ambulatory parameters (BP level, BP variability, and BP load) and AMS.Methods: Sixty-nine subjects were enrolled and all participants ascended Litang (4,100 m above sea level). They were monitored using a 24-h ambulatory blood pressure device and underwent echocardiography within 24 h of altitude exposure. The 2018 Lake Louise questionnaire was used to evaluate AMS.Results: The AMS group comprised more women than men [15 (65.2%) vs. 13 (28.3%), P < 0.001] and fewer smokers [4 (17.4%) vs. 23 (50.0%), P = 0.009]. The AMS group exhibited significant increases in 24-h BP compared to the non-AMS group (24-h SBP variation: 10.52 ± 6.48 vs. 6.03 ± 9.27 mmHg, P = 0.041; 24-h DBP variation: 8.70 ± 4.57 vs. 5.03 ± 4.98 mmHg, P = 0.004). The variation of mean 24-h cBPL (cumulative BP load) (mean 24-h cSBPL: 10.58 ± 10.99 vs. 4.02 ± 10.58, P = 0.016; 24-h mean cDBPL: 6.03 ± 5.87 vs. 2.89 ± 4.99, P = 0.034) was also obviously higher in AMS subjects than in non-AMS subjects after HA exposure. 24-h mean cSBPL variation (OR = 1.07, P = 0.024) and 24-h mean cDBPL variation (OR = 1.14, P = 0.034) were independent risk factors of AMS. Moreover, variation of 24-h mean cSBPL showed a good correlation with AMS score (R = 0.504, P < 0.001).Conclusions: Our study demonstrated that patients with AMS had higher BP and BP load changes after altitude exposure than healthy subjects. Excessive BP load variations were associated with AMS. Thus, BP load could be an effective indicator regarding systemic circulation status of AMS.

The present study was designed to analyze the occurrence of increased blood pressure load in adolescent boys with different circadian blood pressure patterns. Healthy adolescent boys with normal values of both office and mean ambulatory systolic blood pressure (SBP) and diastolic blood pressure (DBP) had 3 types of circadian blood pressure profile: "dippers", "non-dippers", "over-dippers". The occurrence of increased blood pressure load was the highest in the groups with a nocturnal over-dipping pattern for both SBP and DBP.

Background/Aims: Ambulatory blood pressure monitoring (ABPM) in chronic kidney disease (CKD) patients has been extensively studied, but few investigations have attempted to relate ABPM with CKD stages. The objectives of this article were to compare ABPM parameters for the diagnosis and treatment determination of CKD with daytime clinic blood pressure (BP) measurements. We also investigated BP and renal injury in combined hypertension and CKD. We supposed ABPM was important in combined hypertension and CKD. Methods: We compared ABPM in hypertension patients, including 152 patients with combined hypertension and CKD. Patients with combined hypertension and CKD were grouped according to severity into stages 1 through 3 (Stage 1-3) and stages 4 and 5 (Stage 4-5). Results: In the Stage 4-5 group, systolic BP (SBP) (daytime, nighttime and 24 h mean), diastolic BP (DBP), pulse pressure and SBP standard deviations (SD) (daytime and 24 h) were higher. SBP and DBP loads were significantly higher in the Stage 4-5 group. The nighttime load was higher than the daytime load. Mean arterial pressure (MAP) was higher and heart rates (HR) were faster in the Stage 4-5 group. Conclusions: BP load should be a component employed in ABPM to determine cardiovascular risk stratification. MAP and HR might be associated with risk to develop end-stage renal disease.

PubMedID: 20238229 Conflicting results have been reported in small non-homogenous groups of children with chronic renal failure in terms of casual blood pressure and ambulatory blood pressure monitoring (ABPM) parameters and left ventricular hypertrophy (LVH). The aim of our study was to assess the value of ABPM and hematological and biochemical parameters in predicting LVH in children on chronic peritoneal dialysis (CPD). Echocardiography and 24-h ABPM were performed in addition to routine biochemical and hematological evaluations in 47 children on CPD (26 male, 21 female; mean age 14.74±3.52 years). Mean daytime systolic blood pressure (SBP) and mean daytime diastolic blood pressure (DBP) values were found to be higher than the mean casual SBP and DBP (p=0.001) values. Thirty-three (70.2%) children had LVH. The correlations between the left ventricular mass index and ABPM variables were good. Stepwise multiple regression analysis revealed daytime SBP load (ß=0.652; p15% and hematocrit value 31% and daytime SBP load

PubMedID: 17371336 Background: Hypertension is one of the main causes of cardiovascular complications leading to death and allograft dysfunction. The aim of this study was to determine the relationship between the levels of 24 h blood pressure and left ventricular mass index (LVMI) and bi-ventricular tissue Doppler echocardiographic measurements in renal transplant recipients (RTxr) and dialysis patients. Methods: In this cross-sectional study, we evaluated 32 non-diabetic renal transplant recipients (GI) and 18 patients with end-stage renal insufficiency who underwent haemodialysis (GII). Results: The mean follow-up periods were 49.16 ± 38.02 and 56.83 ± 34.14 months in GI and GII, respectively. There were no differences for age, gender, daytime systolic-diastolic blood pressures and loads among the groups. The mean night-time systolic-diastolic blood pressures in GI and GII were 119.77 ± 17.41-77.34 ± 14.46 and 120.23 ± 25.53-76.17 ± 18.77 mmHg, respectively (P I-II = 0.453-0.72). The mean night-time systolic blood pressure loads in GI and GII were 4.92 ± 7.77 and 6.10 ± 8.16%, respectively (P I-II = 0.68). The mean night-time diastolic blood pressure loads were 7.79 ± 7.83 and 8.02 ± 8.28% in GI and GII, respectively (P I-II = 0.55). The mean levels of LVMI in GI and GII were 115.81 ± 28.07 and 128.06 ± 65.72 g/m2, respectively (P I-II = 0.85). The mean levels of left ventricular Em/Am by tissue Doppler echocardiography were 1.13 ± 0.40 and 0.90 ± 0.29, respectively (P I-II = 0.127), while the mean levels of right ventricular Em/Am were 0.89 ± 0.37 and 0.88 ± 0.26, respectively (P I-II = 0.50). Conclusion: After renal transplantation, LVMI and bi-ventricular diastolic dysfunction were not regressed. Daytime and night-time blood pressures and loads were similar in the two groups. We can say that well-controlled daytime blood pressure and load is not sufficient to decrease cardiovascular risk in RTxr. Also, it is important to control of night-time blood pressure and load to reduce cardiovascular risk in RTxr. RTxr should be monitored with ambulatory blood pressure monitoring and tissue Doppler echocardiography. © 2007 The Authors.

Objectives: It has been shown that blood pressure (BP) values measured in obese subjects are higher than the individuals with normal weight, even in normotensive limits. However, data concerning the Ambulatory Arterial Stiffness Index (AASI) and blood pressure load in normotensive obese subjects is lacking. This study was aimed to compare the ambulatory arterial stiffness index and blood pressure load in normotensive obese and healthy controls. Methods: One hundred normotensive obese and one hundred normal weight subjects were included in this study. All subjects underwent 24-hour ambulatory blood pressure monitoring. Ambulatory arterial stiffness index was calculated from 24-hour ambulatory blood pressure monitoring records. Ambulatory arterial stiffness index was defined as one minus the regression slope of unedited 24-h diastolic on systolic blood pressures. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) load values were calculated from 24-hour ambulatory blood pressure monitoring analysis. Results: Ambulatory arterial stiffness index of the obese subjects was significantly higher than the healthy controls (0.48 +/- 0.2 vs. 0.33 +/- 0.11, p= 0.50) (OR: 1.137, 95% CI: 0.915-1.001, p=0.004). Conclusion: Blood pressure load and ambulatory arterial stiffness index are increased in normotensive obese patients. Moreover, body mass index is an independent predictor for an abnormal ambulatory arterial stiffness index. Our results indicate that obese subjects are at higher risk for future cardiovascular events despite normal office BP levels.