Abstract

Recently, relation of daily blood pressure variation and target organ damage is absorbed in essential hypertension. The aim of the study was to evaluate relation of daily blood pressure variation and regional cerebral blood flow (rCBF) in essential hypertension using ambulatory blood pressure monitoring and brain SPECT imaging. The study subjects were 42 essential hypertensive patients with no history of any organ failure. Ambulatory blood pressure was monitored every 30 min for from at 7 to 21:30 as daytime, and monitored every 1 hour for from at 22 to 6 as nighttime. Diurnal variation was defined as a difference of greater than 10% between mean daytime and nighttime mean blood pressure (MBP). The subjects were thus classified as dippers or non-dippers. The rCBF was quantitatively measured by N-isopropyl-p-[123I]iodoamphetamine autoradiography method. Regions of interest on rCBF images were set in the frontal, temporal, parietal, occipital cortex, the basal ganglia and the cerebellum. No significant difference was seen in the age, body mass index, lipid, left ventricular mass index, fasting blood sugar, casual MBP and MBP of all day and daytime between two groups. MBP of nighttime in dippers group was significantly lower and rCBF in all regions in dippers group were significantly higher than those of non-dippers group. On multivariate analysis, dippers and non-dippers are a statistically significant predictor of rCBF in all regions. An absent or lower nocturnal blood pressure fall in hypertensive patients is associated with cerebrovascular damage.

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