Key result
Patients with Cushing's syndrome lacked the normal nocturnal fall in blood pressure observed in patients with essential hypertension, despite maintaining a normal nocturnal fall in heart rate.
Why the study?
Does the circadian rhythm of blood pressure differ between patients with Cushing's syndrome and those with essential hypertension?
Observational (n=17)
Yes
Does the circadian rhythm of blood pressure differ between patients with Cushing's syndrome and those with essential hypertension?
The absence of nocturnal blood pressure dipping in Cushing's syndrome suggests the hypothalamo-pituitary-adrenal axis plays a role in regulating normal circadian blood pressure rhythms.
Answers are grounded in this paper and cite their sources.
Should not yet change practice in Cushing's hypertension; hypothesis-generating for HPA axis regulation of circadian BP rhythms.
IMAI, Y., ABE, K., SASAKI, S., MINAMI, N., NIHEI, M., MUNAKATA, M., SEKINO, H. and YOSHINAGA, K. Daily Variation of Blood Pressure in Patients with Cushing's Syndrome. Tohoku J. exp. Med., 1987, 153 (1) 67-74 - The circadian rhythm of blood pressure (BP) was compared between patients with Cushing's syndrome and those with essential hypertension. In patients with essential hypertension, clear nocturnal falls in systolic and diastolic BP and heart rate (HR) were observed, and there was a positive correlation between HR and systolic or diastolic BP. On the other hand, in patients with Cushing's syndrome, there was no nocturnal fall in BP and instead a rise in some cases. In all cases with Cushing's syndrome there was a nocturnal fall in HR, and consequently no significant correlation between HR and BP in these patients. The present results imply that the normal circadian rhythm of blood pressure may be regulated at least in part by the hypothalamo-pituitary-adrenal system.
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Imai et al. (1987) conducted an observational in Cushing's syndrome and Essential hypertension (n=17). Cushing's syndrome vs. Essential hypertension was evaluated on Nocturnal fall in blood pressure. Patients with Cushing's syndrome lacked the normal nocturnal fall in blood pressure observed in patients with essential hypertension, despite maintaining a normal nocturnal fall in heart rate.
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