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Postural hypotension in hypertensive patients.
Alfonso Lagi1, Antonio Rossi, Aurelio Comelli
1Department of Internal Medicine, Ospedale Santa Maria Nuova, Azienda Sanitaria 10, Firenze, Italy. alfonso.lagi@asf.toscana.it
Blood Pressure
|February 7, 2004
Summary
The orthostatic hypotension and supine hypertension (Hypo-Hyper) pattern affects 5.5% of hypertensive patients, particularly the elderly. This subtype has distinct prognostic implications, with nighttime hypertension linked to adverse cardiovascular events.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Hemodynamics
Background:
- Orthostatic hypotension and supine hypertension (Hypo-Hyper) association noted in prior studies.
- Limited characterization of Hypo-Hyper hemodynamic patterns, comorbidities, and prognosis.
- Need for longitudinal data on Hypo-Hyper patients.
Purpose of the Study:
- Characterize hemodynamic patterns in Hypo-Hyper patients.
- Investigate comorbidity and prognostic implications of Hypo-Hyper.
- Evaluate the effect of therapy on the Hypo-Hyper pattern.
Main Methods:
- Longitudinal study of 615 hypertensive patients from Italian Hospitals.
- Ambulatory blood pressure monitoring (AMAP) and clinical evaluation used.
- 34 patients identified with Hypo-Hyper pattern underwent 10-month follow-up.
Main Results:
- Hypo-Hyper pattern incidence was 5.5% in the studied hypertensive population.
- More frequent in the elderly (mean age 58 years) with diverse underlying pathologies.
- No association found between antihypertensive treatment and Hypo-Hyper.
- Nighttime hypertension linked to increased myocardial hypertrophy and pacemaker implantation.
Conclusions:
- Hypo-Hyper pattern represents a distinct hypertension subtype.
- This subtype has significantly different prognostic implications.
- Further research needed to elucidate pathophysiological mechanisms.