Hakan ZENGİL, Elif Hilal VURALİ, Tarkan Mustafa yamanoğlu, Atiye ÇENGEL

Yaşlı hipertansiflerde 24 saatlik kan basıncı kayıtlarının değerlendirilmesi

Amaç: Günümüzde hipertansiyonun tam ve takibinde Ambulatuar Kan Basıncı Monitörlerinin (AKBM) kullanımı yaygınlaşmaktadır. 24 saatlik tansiyon profilleri hipertansiyonun tiplendirilmesini sağlamaktadır. Bu çalışmanın amacı AKBM uygulanan geriatrik bir grupta kan basıncı profilinin özelliklerinin yas gruplarına göre değerlendirilmesidir. Gereç ve Yöntem: 60 yas üzeri hipertansiflere 24 saat süresince ambulatuar kan basıncı monitörleri uygulandı. Elde edilen veriler yas gruplarına (60-69 yas, 70-79 yas ile 80 yas ve üzeri) ve gece normal kan basıncı azalması (GNKBA) gözlenip gözlenmemesine göre sınıflandırılarak kendi yatış kalkış saatlerine göre analiz edildi. Bulgular: GNKBA olan gönüllülerin, 24 saatlik ortalama ve gündüz di-astolik kan basınçları, gece ortalamaları açısından ise hem sistolik hem diastolik kan basınçları arasındaki fark yas gruplarına göre anlamlıdır. GNKBA olmayan gönüllülerin ise 24 saatlik ve gece ortalamaları açısından sadece diastolik kan basıncı ortalamaları; gündüz ise hem sistolik hem diastolik kan basınçları yas grupları arasındaki fark anlamlıdır. Sabah yükselme ve aksam azalma eğimleri açısından da GNKBA olan ve olmayanlar arasında anlamlı fark bulundu. Sonuç: Yaslı hipertansiflerde AKBM ile elde edilen kan basıncı parametrelerinin belirlenmesi kardiyovasküler risk değerlendirmelerinde ve tedavinin izlenmesinde yararlı olacaktır.

Evaluation of 24 hour blood pressure monitoring data

Purpose: Obtaining blood pressure profiles of longer periods by ambulatory blood pressure monitoring (ABPM) is widely used in the diagnosis, classification, and follow up of hypertension. The aim of this study was to compare blood pressure characteristics via ABPM between age groups of geriatric hypertensives for 24-28 h. Materials and Methods: From hypertensive volunteers older than 60 years 22-26 h ABPM recordings were obtained. The data were classified into age groups (60-69, 70-79, and > 80) and dipping pattern, and analysed with the ABPM-FIT program for each patient according to his or her individual go-to-bed and wake-up times. Results: Our data revealed that means of 24 h, daytime, and nighttime blood pressures decreased with aging in older hypertensives. There were also statistically significant differences between the age groups of dippers and non-dippers in various parameters of 24 h blood pressure profiles. Slopes of morning rise (maximum slope) and evening decrease (minimum slope) in systolic blood pressure were found to differ significantly between dippers and non-dippers. Conclusion: Blood pressure parameters obtained via ABPM monitoring will help in both the evaluation of cardiovascular risk and antihypertensi-ve therapy in older hypertensives.

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