Hipertansiyonlu İrritabl Barsak Sendromlu Hastalarda Klinik Alt Tipler Arasında Kan Basıncı Değişkenliğinin Karşılaştırılması

Amaç: Bu çalışmada, irritabl bağırsak sendromu alt tipleri arasında kan basıncı değişkenliğini karşılaştırmayı amaçladık. Yöntem: Yeni tanı almış irritabl bağırsak sendromu ve mevcut hipertansiyonu olan hastalar çalışmaya dahil edildi. Ortalama gerçek değişkenlik (ARV), ardışık 1 haftalık ev kan basıncı ölçümleri ile hesaplandı. Gruplar kan basıncı değişkenliği açısından karşılaştırıldı. Bulgular: Alt tipler arasında diyastolik ARV benzer bulunurken (p=0,919), sistolik ARV açısından aralarında anlamlı fark bulundu (p<0,001). Sonuç: Kabızlık baskın alt tipi olan irritabl bağırsak sendromu hastalarının sistolik kan basıncı değişkenliği daha yüksek olduğundan, bu hastalar kardiyovasküler komplikasyonlar açısından daha yakından takip edilebilir.

Anahtar Kelimeler:

Kan basıncı, kabızlık, ishal, irritabl barsak sendromu

Comparison of Blood Pressure Variability among Clinical Subtypes in Irritable Bowel Syndrome Patients with Hypertension

Objective: In this study, we aimed to compare blood pressure variability among irritable bowel syndrome subtypes. Methods: Patients with newly diagnosed irritable bowel syndrome and existing hypertension were included in the study. Average real variability (ARV) was calculated by consecutive one week home blood pressure measurements. Groups were compared for blood pressure variability. Results: While diastolic ARV was found to be similar among subtypes (p=0.919), a significant difference was found between them in terms of systolic ARV (p<0.001). Conclusion: Since irritable bowel syndrome patients with constipation-predominant subtype have higher systolic blood pressure variability, these patients can be followed more closely for cardiovascular complications.

Keywords:

blood pressure, constipation, diarrhea, irritable bowel syndrome,

PDF

___

Adriani A, Ribaldone DG, Astegiano M, Durazzo M, Saracco GM, Pellicano R. Irritable bowel syndrome: the clinical approach. Panminerva Med. 2018;60(4):213-222.
Hungin AP, Whorwell PJ, Tack J, Mearin F. The prevalence, patterns and impact of irritable bowel syndrome: an international survey of 40,000 subjects. Aliment Pharmacol Ther. 2003;17(5):643-650.
Ladep NG, Okeke EN, Samaila AA, et al. Irritable bowel syndrome among patients attending General Outpatients' clinics in Jos, Nigeria. Eur J Gastroenterol Hepatol. 2007;19(9):795-799.
Mearin F, Lacy BE, Chang L, et al. Bowel Disorders. Gastroenterology. 2016;S0016-5085(16)00222-5. doi: 10.1053/j.gastro.2016.02.031.
Saiz LC, Gorricho J, Garjón J, Celaya MC, Erviti J, Leache L. Blood pressure targets for the treatment of people with hypertension and cardiovascular disease. Cochrane Database Syst Rev. 2018;7(7):CD010315. doi: 10.1002/14651858.CD010315.pub3.
Bundy JD, Li C, Stuchlik P, et al. Systolic Blood Pressure Reduction and Risk of Cardiovascular Disease and Mortality: A Systematic Review and Network Meta-analysis. JAMA Cardiol. 2017;2(7):775-781.
Rosei EA, Chiarini G, Rizzoni D. How important is blood pressure variability? Eur Heart J Suppl. 2020;22(Suppl E):E1-E6. doi: 10.1093/eurheartj/suaa061.
Parati G, Ochoa JE, Lombardi C, Bilo G. Assessment and management of blood-pressure variability. Nat Rev Cardiol. 2013;10(3):143-155.
Stevens SL, Wood S, Koshiaris C, et al. Blood pressure variability and cardiovascular disease: systematic review and meta-analysis. BMJ. 2016;354:i4098. doi: 10.1136/bmj.i4098.
Del Giorno R, Balestra L, Heiniger PS, Gabutti L. Blood pressure variability with different measurement methods: Reliability and predictors. A proof of concept cross sectional study in elderly hypertensive hospitalized patients. Medicine (Baltimore). 2019;98(28):e16347. doi: 10.1097/MD.0000000000016347.
Zhang B, Wang HE, Bai YM, et al. Inflammatory bowel disease is associated with higher dementia risk: a nationwide longitudinal study. Gut. 2021;70(1):85-91.
Yarur AJ, Deshpande AR, Pechman DM, Tamariz L, Abreu MT, Sussman DA. Inflammatory bowel disease is associated with an increased incidence of cardiovascular events. Am J Gastroenterol. 2011;106(4):741-747.
Coss-Adame E, Rao SS. Brain and gut interactions in irritable bowel syndrome: new paradigms and new understandings. Curr Gastroenterol Rep. 2014;16:379. doi: 10.1007/s11894-014-0379-z.
Zhang Y, Agnoletti D, Blacher J, Safar ME. Blood pressure variability in relation to autonomic nervous system dysregulation: the X-CELLENT study. Hypertens Res. 2012;35(4):399-403.
McCorry LK. Physiology of the autonomic nervous system. Am J Pharm Educ. 2007;71(4):78. doi: 10.5688/aj710478.
van Orshoven NP, Andriesse GI, van Schelven LJ, Smout AJ, Akkermans LM, Oey PL. Subtle involvement of the parasympathetic nervous system in patients with irritable bowel syndrome. Clin Auton Res. 2006;16(1):33-39.
Mancia G, Grassi G. The autonomic nervous system and hypertension. Circ Res. 2014;114(11):1804-1814.
Grassi G, Bombelli M, Seravalle G, Dell'Oro R, Quarti-Trevano F. Diurnal blood pressure variation and sympathetic activity. Hypertens Res. 2010;33(5):381-385.
Mazur M, Furgała A, Jabłoński K, Mach T, Thor P. Autonomic nervous system activity in constipation-predominant irritable bowel syndrome patients. Med Sci Monit. 2012;18(8):CR493-499. doi: 10.12659/msm.883269.
Juhanoja EP, Niiranen TJ, Johansson JK, et al. Outcome-Driven Thresholds for Increased Home Blood Pressure Variability. Hypertension. 2017;69(4):599-607.
Wang J, Shi X, Ma C, et al. Visit-to-visit blood pressure variability is a risk factor for all-cause mortality and cardiovascular disease: a systematic review and meta-analysis. J Hypertens. 2017;35(1):10-17.