RELATION OF SYMPATHETIC NERVOUS SYSTEM ACTIVITY WITH ATTENDED AND UNATTENDED BLOOD PRESSURE LEVELS IN ESSENTIAL HYPERTENSION. (April 2021)

• Record Type: Journal Article
• Authors: Manta, E.; Tsioufis, K.; Leontsinis, I.; Konstantinidis., D.; Kouremeti, M.; Iliakis, P.; Papakonstantinou, P.; Tatakis, F.; Anastasiou, A.; Dimitriadi, M.; Andrikou, I.; Tousoulis, D.
• Is Part Of: Journal of hypertension. Volume 39(2021)e-Supplement 1
• Publication Date: 2021-04
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000745620.28603.10
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Measurement of unattended blood pressure (BP) may have a key role in the assessment of hypertensive patients. Moreover, hypertension is related to sympathetic drive, while there are scarce data on the diverse links of attended and unattended blood pressure with muscle sympathetic nerve activity (MSNA). The aim of this study was to evaluate the association of BP levels in the attended and unattended setting with MSNA in patients with essential hypertension. Design and method: We enrolled 38 patients with essential hypertension (age: 59 ± 11 years, 20 males, office BP: 142/86 ± 19/11 mmHg, 24-hour BP: 137/80 ± 14/12 mmHg), in whom sympathetic drive was assessed by MSNA estimations based on established methodology (microneurography). Both types of BP measurement, attended and unattended (patient alone in the room, an oscillometric device programmed to perform 3 BP measurements, 1 minute apart, after 5 minutes), were conducted with the same device, on the same day of MSNA recording, in random order. Patients were divided into the combined attended and unattended hypertensive group when BP > or = 140/90 mmHg in both attended and unattended BP estimations and to the attended hypertensive group when only attended BP > or = 140/90 mmHg. Results: Patients with combined attended and unattended hypertension (n = 18) compared to those with attended only hypertension (n = 20) were older (61 ± 11 vs 57 ± 11 years, p = 0.03), with no differences regarding metabolic profile, renal function, 24-h ambulatory BP levelsand left ventricular mass index (p = NS for all). In addition, the group of combined hypertension was characterized by greater levels of MSNA, compared to the attended only hypertension group (41.2 ± 11.6 vs 32.2 ± 10.1 bursts per minute, p = 0.031). In all participants, sympathetic nerve traffic as assessed by resting MSNA was related to attended systolic BP (r = 0.459, p = 0.004), attended diastolic BP (r = 0.503, p = 0.001), unattended systolic BP (r = 0.433, p = 0.007) and unattended diastolic BP (r = 0.423, p = 0.008). Conclusions: The phenotype of combined attended and unattended hypertension compared to attended hypertension is accompanied by higher sympathetic nervous system activation. This close association of MSNA with attended and unattended BP levels in essential hypertension further supports the key role of sympathetic drive in modulating BP.