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Heart rate 24 hours (H.T.) and ambulatory blood pressure monitoring 24 hours (A.B.P.M.) levels in males and females with essential hypertension
AJH–APRIL 2000 –VOL. 13, NO. 4, PART 2
POSTERS: Arterial Structure and Compliance
207A
treated with lisinopril. However, carotid wall mass, as measured by IMA, was reduced to a similar extent in the two treatment groups. Vascular regression in the amlodipine treated patients was solely due to a reduction in wall thickness, whilst both IMT and vascular diameter decreased in those patients treated with lisinopril. It remains to be established whether the greater reduction in common carotid IMT achieved in amlodipine treated patients confers additional prognostic advantage.
From our results, only in females H.R. seemed directly joined to ABPM 24 hours. In female sex autonomic nervous systems integrity seems to be more preserved than in male sex, this although in females the length of hypertension was more than in males. The length of hypertension (baroreceptors and vascular damage) seems to decrease this relationship. In females H.R. and Blood Pressure seems to steered by an unique autonomic regulator centre for more time than in male sex.
Key Words: Intima-media thickness; carotid artery; atherosclerosis; amlodipine; lisinopril
Key Words: Heart rate; ambulatory blood pressure monitoring; blood pressure control; male and female sex
B055 HEART RATE 24 HOURS (H.T.) AND AMBULATORY BLOOD PRESSURE MONITORING 24 HOURS (A.B.P.M.) LEVELS IN MALES AND FEMALES WITH ESSENTIAL HYPERTENSION G. Restori, D. Coen, E. Rossi*. Emergency Medicine Department—Az. Ospedale—Parma—ITALY *Medical Department—Az. Ospedale—Reggio Emilia—ITALY Hypertension represent one of the major risk factors to atherosclerosis development, but recently also the heart rate seems to be play an important role. Only few known are the relationships between H.T. and A.B.P.M., aboveall in relation to the sex. To further investigate this relationship we randomly chose 170 essential hypertensives (100 males and 70 females). The subjects shown the following features males: age ⫽ 44 ⫾ 11, Length of Hypertension (L.H.) ⫽ 60 ⫾ 60, Ambulatory Systolic Blood Pressure (ASBP) ⫽ 157 ⫾ 18 mmHg, Ambulatory Diastolic Blood Pressure (ADBP) ⫽ 101 ⫾ 11 mmHg B.M.I. ⫽ 27.8 ⫾ 3.8; females: age ⫽ 48 ⫾ 10, L.H. ⫽ 95 ⫾ 96, B.M.I. ⫽ 27 ⫾ 3.9, ASBP ⫽ 157 ⫾ 18 mmHg, ADBP ⫽ 101 ⫾ 11 mmHg. Each subjects was submitted an A.B.P.M. 24 hours to carry out: H.T., ASBPM (systolic) 24 hours, ASBPM 24 hours standard deviation (ASBPM x), ADBPM (diastolic) 24 hours, ADBPM 24 hours standard deviation (ADBPM x), Nocturnal ASBPM 24 hours (nASBP), Nocturnal ASBPM 24 hours standard deviation (nASBPM x), Nocturnal ADBPM 24 hours (n-ADBPM), Nocturnal ADBP 24 hours standard deviation (n-ADBPM x), Diurnal ASBPM 24 hours (d-ASBPM), Diurnal ASBPM 24 hours standard deviation (d-ASBPM x), Diurnal ADBPM 24 hours (d-ADBPM), Diurnal-ADBP standard deviation (dADBPM x), Systolic Load (SL, n° of systolic values ⬎ 140 mmHg), Diastolic Load (DL, n° of diastolic values ⬎ 90 mmHg). *p⬍0.05, **p⬍0.01, ***p⬍0.001
• • • • • • • • • •
H.R. 24 hours
FEMALES
AGE L.H. d-ASBP x ASBP x DL ADBP d-ADBPM n-ADBPM ADBPM ADBPM x
r⫽⫺0.35** r⫽⫺0.38*** r⫽0.39*** r⫽0.40*** r⫽0.30** r⫽0.26* r⫽0.33* r⫽0.28* r⫽0.37*** r⫽0.37***
MALES
B056 HEART RATE 24 HOURS MONITORING (H.T.M.) AND SOME PARAMETERS OF CARDIOVASCULAR RISK PROFILE IN MALES AND FEMALES WITH ESSENTIAL HYPERTENSION G. Restori, D. Coen, E. Rossi*. Emergency Medicine Department—Az. Ospedale—Parma—* Med. Department—Az. Ospedale—Reggio Emilia—ITALY Heart rate (H.R.) seems to play an important role as cardiovascular risk factor above all in hypertension. Indeed H.R. directly can influence either blood pressure or endothelial shear stress and wear; indirectly H.R. represent a parameter of sympatic nervous system activity, an other cause of vascular damage. In this study we essayed the relationships between H.R.M. and some parameters (anthropometric, bioumoral and echocardiographic) of cardiovascular risk profile. We randomly choose 170 essential hypertensives (100 males and 70 females). The subjects shown the following features males: age ⫽ 44 ⫾ 11, Length of Hypertension (L.H.) ⫽ 60 ⫾ 60, Ambulatory Systolic Blood Pressure (ASBP) ⫽ 157 ⫾ 18 mmHg, Ambulatory Diastolic Blood Pressure (ADBP) ⫽ 101 ⫾ 11 mmHg B.M.I. ⫽ 27.8 ⫾ 3.8; females: age ⫽ 48 ⫾ 10, L.H. ⫽ 95 ⫾ 96, B.M.I. ⫽ 27 ⫾ 3.9, ASBP ⫽ 157 ⫾ 18 mmHg, ADBP ⫽ 101 ⫾ 11 mmHg. Each subjects was submitted to an Holter and an echocardiographic evaluation test [Tele-diastolic diameter (T.D.), Telesystolic diameter (T.S.), Interventricular Thickness (R.T.R.), Posterior Wall Thickness (P.W.T.), Shortening Fraction (S.F.), Left Radium/Thickness Ratio (L.T.R.), Left Ventricular Mass (L.V.M.), Left Ventricular Mass Index (L.V.M.I.)]. In basal conditions and after a diet with sodium intake controlled, we take also a blood sample to value: Plasma Renin Activity (P.R.A.), Plasma Aldosterone (P.A.), glomerular flow (G.F.), Serum Calcium (S.C.), Serum Ionised Calcium (S.I.C.), Serum Magnesium, Serum Phosphoremia (S.P.), Serum Glycemia (S.G.). In the table are shown the relationships between H.R.M. and parameters essayed. *p⬍0.05, **p⬍0.01, ***p⬍0.001
H.R.M.
FEMALES
MALES
r⫽0.23* • • • • •
P.R.A. S.C.I. Body Weight Body Surface R.T.R.
r⫽0.25* r⫽0.38* r⫽0.30* r⫽0.30* r⫽⫺0.25*
POSTERS: Arterial Structure and Compliance
207A
treated with lisinopril. However, carotid wall mass, as measured by IMA, was reduced to a similar extent in the two treatment groups. Vascular regression in the amlodipine treated patients was solely due to a reduction in wall thickness, whilst both IMT and vascular diameter decreased in those patients treated with lisinopril. It remains to be established whether the greater reduction in common carotid IMT achieved in amlodipine treated patients confers additional prognostic advantage.
From our results, only in females H.R. seemed directly joined to ABPM 24 hours. In female sex autonomic nervous systems integrity seems to be more preserved than in male sex, this although in females the length of hypertension was more than in males. The length of hypertension (baroreceptors and vascular damage) seems to decrease this relationship. In females H.R. and Blood Pressure seems to steered by an unique autonomic regulator centre for more time than in male sex.
Key Words: Intima-media thickness; carotid artery; atherosclerosis; amlodipine; lisinopril
Key Words: Heart rate; ambulatory blood pressure monitoring; blood pressure control; male and female sex
B055 HEART RATE 24 HOURS (H.T.) AND AMBULATORY BLOOD PRESSURE MONITORING 24 HOURS (A.B.P.M.) LEVELS IN MALES AND FEMALES WITH ESSENTIAL HYPERTENSION G. Restori, D. Coen, E. Rossi*. Emergency Medicine Department—Az. Ospedale—Parma—ITALY *Medical Department—Az. Ospedale—Reggio Emilia—ITALY Hypertension represent one of the major risk factors to atherosclerosis development, but recently also the heart rate seems to be play an important role. Only few known are the relationships between H.T. and A.B.P.M., aboveall in relation to the sex. To further investigate this relationship we randomly chose 170 essential hypertensives (100 males and 70 females). The subjects shown the following features males: age ⫽ 44 ⫾ 11, Length of Hypertension (L.H.) ⫽ 60 ⫾ 60, Ambulatory Systolic Blood Pressure (ASBP) ⫽ 157 ⫾ 18 mmHg, Ambulatory Diastolic Blood Pressure (ADBP) ⫽ 101 ⫾ 11 mmHg B.M.I. ⫽ 27.8 ⫾ 3.8; females: age ⫽ 48 ⫾ 10, L.H. ⫽ 95 ⫾ 96, B.M.I. ⫽ 27 ⫾ 3.9, ASBP ⫽ 157 ⫾ 18 mmHg, ADBP ⫽ 101 ⫾ 11 mmHg. Each subjects was submitted an A.B.P.M. 24 hours to carry out: H.T., ASBPM (systolic) 24 hours, ASBPM 24 hours standard deviation (ASBPM x), ADBPM (diastolic) 24 hours, ADBPM 24 hours standard deviation (ADBPM x), Nocturnal ASBPM 24 hours (nASBP), Nocturnal ASBPM 24 hours standard deviation (nASBPM x), Nocturnal ADBPM 24 hours (n-ADBPM), Nocturnal ADBP 24 hours standard deviation (n-ADBPM x), Diurnal ASBPM 24 hours (d-ASBPM), Diurnal ASBPM 24 hours standard deviation (d-ASBPM x), Diurnal ADBPM 24 hours (d-ADBPM), Diurnal-ADBP standard deviation (dADBPM x), Systolic Load (SL, n° of systolic values ⬎ 140 mmHg), Diastolic Load (DL, n° of diastolic values ⬎ 90 mmHg). *p⬍0.05, **p⬍0.01, ***p⬍0.001
• • • • • • • • • •
H.R. 24 hours
FEMALES
AGE L.H. d-ASBP x ASBP x DL ADBP d-ADBPM n-ADBPM ADBPM ADBPM x
r⫽⫺0.35** r⫽⫺0.38*** r⫽0.39*** r⫽0.40*** r⫽0.30** r⫽0.26* r⫽0.33* r⫽0.28* r⫽0.37*** r⫽0.37***
MALES
B056 HEART RATE 24 HOURS MONITORING (H.T.M.) AND SOME PARAMETERS OF CARDIOVASCULAR RISK PROFILE IN MALES AND FEMALES WITH ESSENTIAL HYPERTENSION G. Restori, D. Coen, E. Rossi*. Emergency Medicine Department—Az. Ospedale—Parma—* Med. Department—Az. Ospedale—Reggio Emilia—ITALY Heart rate (H.R.) seems to play an important role as cardiovascular risk factor above all in hypertension. Indeed H.R. directly can influence either blood pressure or endothelial shear stress and wear; indirectly H.R. represent a parameter of sympatic nervous system activity, an other cause of vascular damage. In this study we essayed the relationships between H.R.M. and some parameters (anthropometric, bioumoral and echocardiographic) of cardiovascular risk profile. We randomly choose 170 essential hypertensives (100 males and 70 females). The subjects shown the following features males: age ⫽ 44 ⫾ 11, Length of Hypertension (L.H.) ⫽ 60 ⫾ 60, Ambulatory Systolic Blood Pressure (ASBP) ⫽ 157 ⫾ 18 mmHg, Ambulatory Diastolic Blood Pressure (ADBP) ⫽ 101 ⫾ 11 mmHg B.M.I. ⫽ 27.8 ⫾ 3.8; females: age ⫽ 48 ⫾ 10, L.H. ⫽ 95 ⫾ 96, B.M.I. ⫽ 27 ⫾ 3.9, ASBP ⫽ 157 ⫾ 18 mmHg, ADBP ⫽ 101 ⫾ 11 mmHg. Each subjects was submitted to an Holter and an echocardiographic evaluation test [Tele-diastolic diameter (T.D.), Telesystolic diameter (T.S.), Interventricular Thickness (R.T.R.), Posterior Wall Thickness (P.W.T.), Shortening Fraction (S.F.), Left Radium/Thickness Ratio (L.T.R.), Left Ventricular Mass (L.V.M.), Left Ventricular Mass Index (L.V.M.I.)]. In basal conditions and after a diet with sodium intake controlled, we take also a blood sample to value: Plasma Renin Activity (P.R.A.), Plasma Aldosterone (P.A.), glomerular flow (G.F.), Serum Calcium (S.C.), Serum Ionised Calcium (S.I.C.), Serum Magnesium, Serum Phosphoremia (S.P.), Serum Glycemia (S.G.). In the table are shown the relationships between H.R.M. and parameters essayed. *p⬍0.05, **p⬍0.01, ***p⬍0.001
H.R.M.
FEMALES
MALES
r⫽0.23* • • • • •
P.R.A. S.C.I. Body Weight Body Surface R.T.R.
r⫽0.25* r⫽0.38* r⫽0.30* r⫽0.30* r⫽⫺0.25*