What is the clinical evidence from this study?

Study design: Observational. Population: Essential hypertension, stage II (n=130). Intervention: 24 hour ambulatory blood pressure monitoring vs. Middle-aged vs elderly patients, and healthy controls. Primary outcome: 24 hour ambulatory blood pressure monitoring indices (average and maximal DBP) (p=<0.001).

What does this research mean for the field?

In patients with essential hypertension, advancing age is associated with a significant decrease in average and maximal daily diastolic blood pressure alongside a steady increase in systolic blood pressure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

September 30, 2022Open Access

Peculiarities of 24 Hour Ambulatory Blood Pressure Monitoring Indices in Hypertensive Patients of Different Age Groups

Q: What are the key findings of this study?

Elderly hypertensive patients had significantly lower average daily and maximal daily diastolic blood pressure compared to middle-aged hypertensive patients (by 7.4%, p<0.001 and 13.1%, p<0.05).

Q: What does this research mean for the field?

In patients with essential hypertension, advancing age is associated with a significant decrease in average and maximal daily diastolic blood pressure alongside a steady increase in systolic blood pressure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Elderly hypertensive patients had significantly lower average daily and maximal daily diastolic blood pressure compared to middle-aged hypertensive patients (by 7.4%, p<0.001 and 13.1%, p<0.05).

Study Design

Type

Observational (n=130)

Structured PICO

Population

130 patients divided into 4 groups: middle-aged hypertensive patients (45-59 years old, n=57), elderly hypertensive patients (60-74 years old, n=43), middle-aged controls without essential hypertension (n=15), and elderly controls without essential hypertension (n=15).

Outcome

24-hour ambulatory blood pressure monitoring indices including average daily SBP/DBP, maximal daily SBP/DBP, and daily index (percentage of BP decrease at night)surrogate

In hypertensive patients, diastolic blood pressure decreases with age while systolic blood pressure steadily increases, highlighting age-specific differences in ambulatory blood pressure profiles.

Main Result

p-value: p=<0.001

Abstract

Relevance. Until now, there is an ongoing debate about the value of different indicators of blood pressure (BP) − systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse blood pressure (PBP) as predictors of essential hypertension (EH). In this regard the issue of target BP levels in patients of different ages remains studied incompletely. Objective is to determine peculiarities of 24 hour ambulatory blood pressure monitoring indices in patients with essential hypertension, stage II of different age groups. Materials and methods. ABPM indicators were determined in 130 patients who were divided into 4 groups. 1st group (n=57) – middle-aged hypertensive patients (45-59 years old); 2nd group (n=43) – elderly hypertensive patients (60-74 years old); 3rd group (n=15) – middle-aged patients without EH – control for the 1st group; 4th group (n=15) − elderly patients without EH − control for the 2nd group. Indices of ABPM were determined using a portable recorder ABPM-04 (company "Meditech", Hungary). Measurements of BP were performed every 15 minutes during the day (from 6 to 22 hours) and every 30 minutes at night (from 22 to 6 hours). We determined the following indices: the average daily SBP (mm Hg), the average daly DBP (mm Hg), the average BP (mm Hg); the maximal daily SBP (mm Hg), the maximal daily DBP (mm Hg). The daily index (DI) was also calculated − the percentage of BP decrease at night compared to daytime BP calculated in % DI of SBP, DI of DBP, DI of average BP. Results. In group 1 the average and maximal DBP were lower than in group 2 by 7,4% (p0,05): heart rate by 8,6% and was 63,0±9,1/min., DI SBP by 17,6% and was 8,9±5,5%; DI DBP by 16,1% and was 14,1±7,1%; DI of average BP– by 20,4% and was equal to 11,3±6,1%. Conclusions. It is found that with the age DBP decreases with steadily increased SBP in hypertensive patients. The average daily and the maximal daily DBP are significantly less by 7,4% (p<0,001) and 13,1% (p<0,05) accordingly in elderly patients compared with the middle-aged.