Andrew M. Ball, MS, PT
Posts: 500
Joined: October 8, 1999
From: Chapel Hill, NC, USA
Status: offline
|
Phillips RA. Nondipping Nighttime Blood Pressure Linked to Stroke. American Journal of Hypertension 2000;13:1250-1255.
Blood pressure that does not fall during sleep appears to be an independent risk factor for stroke. The study found that people who had already had a stroke were much more likely to later have the phenomenon--known as ''nondipping''--than were similar people who had not had strokes. Though the investigators could not draw a causal relationship between nondipping and stroke, they did conclude that the link was strong enough to recommend ambulatory blood pressure monitoring become a routine part of stroke risk assessments.
Researchers from the Mount Sinai School of Medicine in New York studied 166 stroke survivors with one-time, 24-hour ambulatory blood pressure monitoring. Sixty-three of the patients were African American, 61 were white, and 42 were Caribbean Hispanic. The group was approximately split between women and men.
After monitoring, 64% of the patients were classified as nondippers because their systolic and diastolic blood pressure dropped less than 10% during sleep. Only 37% of similarly-monitored comparison study participants (who had never had strokes) demonstrated the nondipping phenomenon. White patients with nondipping nighttime blood pressure were more than four times more likely to have suffered a stroke than were white patients with lower nighttime blood pressure, even after other stroke risks were factored out. Nondipping doubled the chances of having had a stroke in blacks and Caribbean Hispanics.
Further analysis showed that nondipping blood pressure was as strong a predictor of stroke history as smoking, a history of diabetes, or a history of hypertension. ``This was a case controlled study, which by nature can't show a causal relationship'' between nondipping blood pressure and stroke, lead investigator Dr. Robert A. Phillips told Reuters Health in an interview. But these results combined with prospective data from Italy showing that nondipping blood pressure predicted stroke risk ``make me believe that (nondipping) is very likely associated with an increased risk of stroke,'' he said.
Phillips told Reuters Health that the data in his study were compelling enough to justify ambulatory blood pressure monitoring in patients with suspected stroke risk factors.
``Ambulatory monitoring is really underutilized,'' said Phillips, a cardiologist. ``It's not done because there is no reimbursement for it, but it really is useful,'' he added.
___________________________
Is this kind of pre-stroke testing a potential niche market for PT's? Would it be done at home, or as an inpatient sleep study? Why would PT's be more qualified than other disciplines to provide this service?
|
Printable Version
Nondipping Nightime BP testing . . . a new niche for PT? - 
New Messages
No New Messages
Hot Topic w/ New Messages
Hot Topic w/o New Messages
Locked w/ New Messages
Locked w/o New Messages
Post New Thread