RELATIONSHIP BETWEEN CIRCADIAN BLOOD PRESSURE PATTERN AND CORONARY SLOW FLOW

Document Type : Original Article

Authors

1 Department of Cardiology, Faculty of Medicine, Zagazig University, Egypt.

2 Cardiology Department, Al-Ahrar Teaching Hospital

Abstract

Background: Dipper hypertension referred to a drop of more than 10% in nocturnal blood pressure during the circadian rhythm while a decrease less than 10 % is referred to non-dipper. Coronary slow flow is associated with severe cardiovascular complications myocardial ischemia, malignant arrhythmias, and cardiovascular mortality. Aim of the work: We aimed to examine the relationship between circadian blood pressure pattern and thrombolysis in myocardial infarction (TIMI) frame count, which is an indicator for coronary slow flow. Methods: This is a comparative cross-sectional study that included patients with symptoms of typical chest pain or angina equivalent with or without stress test who underwent elective coronary angiography, and their blood pressures were followed up with ambulatory blood pressure monitoring (ABPM). The patients were divided as dipper and non-dipper hypertensives. The data of ABPM and the thrombolysis in myocardial infarction (TIMI) frame count were compared between the compared groups. Results: A total of 60 patients (26 males and 24 females) were included. Twenty-three patients were in the dipper group and 37 patients in the non-dipper group. Regarding ABPM over 24 hours, the non-dipper group had higher levels in terms of mean BP, mean systolic BP and pulse pressure (PP) than the dipper group. Regarding daytime ABPM, the non-dipper group had higher levels in terms of mean BP, mean systolic BP, and PP than the dipper group. Regarding nighttime ABPM, the non-dipper group had higher levels in terms of mean BP, mean systolic BP, mean diastolic BP, and PP than the dipper group. Conclusion: Coronary slow flow diagnosis with higher TIMI frame count was observed to be higher in non-dipper hypertensive patients in comparison to in dipper hypertensives.

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