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Nocturnal Blood Pressure Dipping is Abolished in Old-Elderly Hospitalized Patients

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Abstract

Introduction

During sleep there is reduction of blood pressure (BP) caused by a decrease of the sympathetic nervous tone. This nocturnal “dipping” phenomenon, assessable with ambulatory blood pressure monitoring (ABPM), is blunted with increasing age.

Aim

To assess the effect of hospitalization on night-time BP fall in old-elderly patients.

Methods

We analysed 78 ABPM of old-elderly hospitalized patients (mean age 91 ± 0.5 years) and those of 18 outpatients as control group. The nocturnal BP fall was assessed calculating: the dipping value (DV) i.e. the difference between mean diurnal systolic BP (mDSBP) and mean nocturnal systolic BP (mNSBP) and the “dipping pattern” i.e. mNSBP/mDSBPx100.

Results

Hospitalized patients showed a lower rate of normal dipping patterns (9 vs. 39%), an higher rate of reverse dippers (59 vs. 28%; p < 0.05) and a lower DV (−0.9 ± 1 vs. 9 ± 4 mmHg; p < 0.05) than patients of control group. At multivariate regression analysis including age, gender and hospitalization, DV was significantly correlated only with the hospitalization (β −0.3, t −2.9; p < 0.05).

Conclusions

In old-elderly hospitalized patients nocturnal BP fall is abolished. This enhancement of the age related reduction of nocturnal BP dipping may be due to the stress associated with hospital environment.

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Authors and Affiliations

  1. Division of Internal Medicine, Poveri Infermi Hospital, Loc. San Bernardino, 4, 17073, Ceva, CN, Italy

    Francesco Salvo, Michele Berardi, Andrea Riccardo Errani & Carlo Lorenzo Muzzulini

  2. Department of Internal Medicine and Hypertension Center, S. Giuseppe Hospital, Via San Vittore, 12, 20123, Milan, Italy

    Chiara Lonati

  3. Centre of Clinical Physiology, Hypertension, Policlinico Hospital, University of Milan, Via Francesco Sforza, 25, 20122, Milan, Italy

    Alberto Morganti

Authors
  1. Francesco Salvo
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  2. Chiara Lonati
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  3. Michele Berardi
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  4. Andrea Riccardo Errani
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  5. Carlo Lorenzo Muzzulini
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  6. Alberto Morganti
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Correspondence to Francesco Salvo.

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The authors declare no conflict of interest.

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This article refers to retrospective analysis of ABPMs recorded with the informed consent of patients.

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Salvo, F., Lonati, C., Berardi, M. et al. Nocturnal Blood Pressure Dipping is Abolished in Old-Elderly Hospitalized Patients. High Blood Press Cardiovasc Prev 24, 413–417 (2017). https://doi.org/10.1007/s40292-017-0224-1

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  • DOI: https://doi.org/10.1007/s40292-017-0224-1

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