Research published in Lancet confirms the key role of nocturnal hypertension as a cardiovascular (and non-cardiovascular) risk factor. Ideal values for health
L’increased blood pressure at night more dangerous than the daytime one. L’hypertension nighttime, measured through 24-hour monitoring (otherwise known as Pressure Holter), would in fact affect the risk of death from cardiovascular (and non-cardiovascular) causes), compared to daytime pressure. one of the most relevant observations that emerged from a large study published in the scientific journal The Lancet. More than 59 thousand patients from a Spanish registry were examined in the research and kept under observation for 10 years.
The study compared the predictive value of blood pressure measurement in 24 hours compared to that performed by the doctor on deaths due to cardiovascular causes and for all causes, finding a series of interesting data that confirm results already observed in the past, on smaller numbers .
First of all, the study confirms that the High systolic pressure (the “maximum”) is the most dangerous – explains Marina Alimento of the Heart Failure, Clinical and Rehabilitation Cardiology Operational Unit of the Monzino Cardiology Institute in Milan -. She in particular highlights that the systolic blood pressure assessed over 24 hours correlates 5 times more with death than the systolic measured in the office, by the doctor or by a nurse. Furthermore, by analyzing night-time blood pressure values separately from those during the day and over 24 hours, the Spanish researchers saw that the nocturnal blood pressure measurement gives 6 times more precise information compared to the systolic blood pressure measured in the clinic in relation to the risk of mortality.
Greater risk if high even at night
Usually people who have high blood pressure are at night hypertensive even during the daybut failure to reduce blood pressure at nightwhen the heart should start to beat more slowly and blood pressure should decrease, it can expose them to a greater risk of cardiovascular events. Typically these people present a hyperactivation of the sympathetic nervous system, responsible for managing stressful situations in the body. This pathological behaviorwith nocturnal increase in blood pressure and heart rate, it can be modulated with some antihypertensive drugs which act on this component of the autonomic nervous system – explains the expert -. To counteract nocturnal hypertension you can also adopt other precautionsas take blood pressure medications in the evening instead of in the morning. In this way the therapy is used when it is most effective, i.e. in the first 12 hours after intake.
When treating a hypertensive person, it is still necessary to take this into consideration several factors and, to start off on the right foot, it is essential to carefully determine the characteristics of the hypertensive state. To understand the situation well, it is not enough to measure the blood pressure in the clinic. good rAlso use blood pressure Holterexecuted before setting up any therapy or to monitor its effectiveness. In fact, blood pressure can have different characteristics and these must be identified, observes Alimento.
The white coat effect
For example, it is important to distinguish forms of sustained hypertension from the so-called white coat high blood pressure or from that masquerade
. L’white coat hypertension frequently encountered and occurs when high blood pressure values are detected in the doctor’s office, but normal at home and on 24-hour monitoring, while in themasked hypertension the opposite happens: the blood pressure values are normal during the visit, while they are increased on the Holter – clarifies the cardiologist -. L’“sustained hypertension” instead characterized by high values both when the pressure is measured in the clinic and during 24-hour monitoring.
As the new Spanish study also points out, theMasked hypertension should not be underestimated: it is in fact associated with an increased risk, which is not observed with white coat hypertension.
High blood pressure it generally causes no symptoms. Sometimes, however, they can be caught some signsamong which heachache in people who have never suffered from it, the reduced tolerance to light stressor again, the frequent need to urinate at night. To confirm the rise in blood pressure, it is necessary to measure it with a sphygmomanometer. The specialist may suggest performing 24-hour monitoring.
At what age to check your blood pressure
There is no specific age at which to start checking your blood pressure, however 20 years are considered a good time to annual measurementswhile passed i 40 years
the doctor will indicate the cadence optimal controls, depending Also the presence of risk factorsas smoke, cholesterol
high, sedentary lifestyle, etc. signals Food. Blood pressure normal when the systolic value is less than 140 mmHg (millimeters of mercury) and that diastolic at 90 mmHg. Ideal for health I am, values lower than 130/85 mmHg.
Meaning of the difference between maximum and minimum
When treating hypertension, another important parameter must also be taken into consideration, the so-called differential pressureor the difference between the maximum and the minimum. Pi the minimum and maximum pressure they are distant, the higher the differential pressure will be. For example, if the systolic pressure is 160 and the diastolic pressure is 80, the differential pressure will be 80 mmHg, a value considered high. A’high differential pressure
reflects an increase in stiffness of the large arteries, which generally concerns the elderly – explains Alimento -. A high value of the differential associated with a greater cardiovascular risk. Unfortunately there is no specific therapy, but the antihypertensive treatment can be calibrated, for example by making do with bringing the systolic to 150-140 to prevent the diastolic from decreasing too much, given that antihypertensive drugs act on both. It’s a balancing act.
FORUM The doctor responds Of Courier Health
November 14, 2023 (modified November 14, 2023 | 08:37)
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