Ondřej Petrák1, Ján Rosa1, Robert Holaj1, Branislav Štrauch1, Zuzana Krátká1, Jan Kvasnička1, Judita Klímová1, Petr Waldauf2, Barbora Hamplová1, Alice Markvartová1, Květoslav Novák3, David Michalský4, Jiří Widimský1, Tomáš Zelinka1. 1. Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic. 2. Department of Anesthesiology, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University in Prague, Prague 2, Czech Republic. 3. Department of Urology, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic. 4. First Department of Surgery, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic.
Abstract
CONTEXT: Impaired diurnal blood pressure (BP) variability is related to higher cardiovascular risk. OBJECTIVE: To assess diurnal variability of BP and its relation to target organ damage (TOD) and catecholamine phenotype in a consecutive sample of pheochromocytoma/paraganglioma (PPGL). DESIGN: We included 179 patients with PPGL All patients underwent 24 hours of ambulatory BP monitoring to determine dipping status. Differences in plasma metanephrine or urine adrenaline were used to distinguish catecholamine biochemical phenotype. To evaluate TOD, renal functions, presence of left ventricle hypertrophy (LVH), and the subgroup (n = 111) carotid-femoral pulse wave velocity (PWV) were assessed. Structural equation modeling was used to find the relationship among nocturnal dipping, catecholamine phenotype, and TOD parameters. RESULTS: According to the nocturnal dipping, patients were divided into the three groups: dippers (28%), nondippers (40%), and reverse dippers (32%). Reverse dippers were older (P < 0.05), with a higher proportion of noradrenergic (NA) phenotype (P < 0.05), a higher prevalence of diabetes mellitus (P < 0.05), and sustained arterial hypertension (P < 0.01) and its duration (P < 0.05), as opposed to the other groups. All parameters of TOD were more pronounced only in reverse dippers compared with nondippers and dippers. The presence of NA phenotype (=absence of adrenaline production) was associated with reverse dipping and TOD (LVH and PWV). CONCLUSIONS: Patients with reverse dipping had more substantial TOD compared with other groups. The NA phenotype plays an important role, not only in impaired diurnal BP variability but also independently from dipping status in more pronounced TOD of heart and vessels.
CONTEXT: Impaired diurnal blood pressure (BP) variability is related to higher cardiovascular risk. OBJECTIVE: To assess diurnal variability of BP and its relation to target organ damage (TOD) and catecholamine phenotype in a consecutive sample of pheochromocytoma/paraganglioma (PPGL). DESIGN: We included 179 patients with PPGL All patients underwent 24 hours of ambulatory BP monitoring to determine dipping status. Differences in plasma metanephrine or urine adrenaline were used to distinguish catecholamine biochemical phenotype. To evaluate TOD, renal functions, presence of left ventricle hypertrophy (LVH), and the subgroup (n = 111) carotid-femoral pulse wave velocity (PWV) were assessed. Structural equation modeling was used to find the relationship among nocturnal dipping, catecholamine phenotype, and TOD parameters. RESULTS: According to the nocturnal dipping, patients were divided into the three groups: dippers (28%), nondippers (40%), and reverse dippers (32%). Reverse dippers were older (P < 0.05), with a higher proportion of noradrenergic (NA) phenotype (P < 0.05), a higher prevalence of diabetes mellitus (P < 0.05), and sustained arterial hypertension (P < 0.01) and its duration (P < 0.05), as opposed to the other groups. All parameters of TOD were more pronounced only in reverse dippers compared with nondippers and dippers. The presence of NA phenotype (=absence of adrenaline production) was associated with reverse dipping and TOD (LVH and PWV). CONCLUSIONS:Patients with reverse dipping had more substantial TOD compared with other groups. The NA phenotype plays an important role, not only in impaired diurnal BP variability but also independently from dipping status in more pronounced TOD of heart and vessels.
Authors: Sabina Oreska; Hana Storkanova; Jaroslav Kudlicka; Vladimir Tuka; Ondrej Mikes; Zdislava Krupickova; Martin Satny; Eva Chytilova; Jan Kvasnicka; Maja Spiritovic; Barbora Hermankova; Petr Cesak; Marian Rybar; Karel Pavelka; Ladislav Senolt; Herman Mann; Jiri Vencovsky; Michal Vrablik; Michal Tomcik Journal: Front Med (Lausanne) Date: 2022-05-03
Authors: M Araujo-Castro; E Pascual-Corrales; L Nattero Chavez; A Martínez Lorca; T Alonso-Gordoa; J Molina-Cerrillo; J Lorca Álvaro; C Mínguez Ojeda; S Redondo López; R Barberá Durbán; R Polo López; N Moreno Mata; U Caballero Silva; H Pian; I Ruz-Caracuel; A Sanjuanbenito Dehesa; V Gómez Dos Santos; A B Serrano Romero Journal: J Endocrinol Invest Date: 2021-07-25 Impact factor: 4.256