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Published on: April 27, 2019
Analysis of 24-Hour Blood Pressure Profile and Antihypertensive Therapy in Male Heart Transplant Patients
Wioletta Raczyńska1, Alicja Radtke-Łysek1, Michał Bohdan1
1First Department of Cardiology, Medical University of Gdańsk, 80-952 Gdańsk, Poland.
Insights
Heart transplant recipients have higher rates of hypertension and abnormal night-time blood pressure patterns compared to controls. Tailored hypertension management, including chronotherapy, is crucial for these patients.
Area of Science:
- Cardiology
- Nephrology
- Transplantation Medicine
Background:
- Improved survival post-heart transplantation is noted, yet hypertension remains a significant complication.
- Understanding the 24-hour blood pressure profile in heart transplant recipients is essential for effective management.
Purpose of the Study:
- To evaluate the 24-hour blood pressure profile in heart transplant recipients.
- To compare hypertension prevalence and treatment in heart transplant recipients versus a control group.
Main Methods:
- Retrospective analysis of 26 male heart transplant recipients and 39 male controls.
- Data collection included 24-hour ambulatory blood pressure monitoring, laboratory tests, and medical history.
Main Results:
- Hypertension diagnosed in 76.9% of heart transplant recipients vs. 56.4% of controls.
- Elevated nocturnal diastolic blood pressure (≥70 mmHg) in 76.9% of recipients.
- Significantly higher prevalence of reverse dippers and isolated nocturnal hypertension in recipients.
Conclusions:
- Heart transplant recipients exhibit distinct 24-hour blood pressure patterns, including nocturnal hypertension.
- A personalized approach to hypertension management, incorporating chronotherapy, is necessary for heart transplant recipients.
Abstract:
Background: Although there has been an improvement in the survival rates of patients following heart transplantation, many complications, such as hypertension, continue to develop. The aim of the study was to assess the 24-hour blood pressure profile and hypertension treatment among patients after heart transplantation and comparison to the control group. Methods: A retrospective data analysis included 26 male patients post-heart transplantation and 39 male patients in the control group. During a routine visit, the following data were collected: 24-hour blood pressure monitoring, laboratory tests, and medical history. Results: Hypertension was diagnosed in 76.9% of heart transplant recipients (HTXr) and in 56.4% of the control group (Cx). During the night-time rest period, diastolic blood pressure values ≥ 70 mmHg were observed in 76.9% of HTXr (vs. 33.33% Cx, p = 0.001). The average daytime systolic/diastolic blood pressure did not differ significantly between the groups. It was also observed that the groups differed in circadian blood pressure (Chi2ML = 15.87, p < 0.001), as there were significantly more reverse dippers in HTXr than in the control group (30.8% (8) vs. 10.3% (4)). The same proportions were also noted in HTXr and the control group in terms of isolated nocturnal hypertension. Conclusions: Heart transplant recipients require a tailored approach to hypertension management, including a variety of medications and appropriate chronotherapy.
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