SCORE Kardiyovasküler Risk Puanlama Sistemi ile Non-dipper Hipertansiyon Arasındaki İlişki

Year 2018, Volume: 45 Issue: 4, 379 - 386, 13.12.2018

Fatih Öksüz , Cagrı Yayla

https://doi.org/10.5798/dicletip.497883

Abstract

Amaç: Non-dipper kan basıncının (KB) uç organ hasarı ve
ölümcül - ölümcül olmayan kardiyovasküler hastalıklarla (KVH) anlamlı şekilde
ilişkili olduğu gösterilmiştir. Kardiyovasküler (KV) olay riskinde artış
bulunan bireylerde sistematik KV risk değerlendirmesi önerilir. SCORE risk
sistemi, ilk ölümcül aterosklerotik olayın 10 yıllık riskini değerlendirir. Bu
çalışmanın amacı hipertansiyon (HT)hastalarında non-dipper KB ile SCORE risk
sistemi arasındaki bir ilişki olup olmadığının araştırılmasıdır.

Yöntemler: Bu çalışma retrospektif bir çalışmadır ve
esansiyel HT tanısı konulan ardışık 213 hastayı içermektedir. Non-dipper ve
dipper hasta grupları 24 saatlik ambulatuar kan basıncı izlemine (AKBİ) göre belirlendi.
SCORE sistemine göre yaş, cinsiyet, sigara kullanımı, sistolik kan basıncı
(SKB) ve total kolesterol (TK) gibi risk faktörleri kullanılarak 10 yıllık
ölümcül KV olay riski hesaplandı.

Bulgular: Non-dipper HT hasta grubunda SCORE risk sistemi anlamlı olarak
yüksek saptandı (p=0.017). Ayrıca sigara içme alışkanlığı sıklığı ve TK
değerleri non-dipper
HT’li hasta grubunda anlamlı olarak daha yüksek saptandı. Diğer demografik,
klinik ve laboratuvar parametreler iki grup arasında benzerdi. SCORE risk oranı
ile gece sistolik ve diyastolik KB’leri arasında orta derecede olmasına rağmen
anlamlı pozitif korelasyon izlendi (r = 0.354, p < 0.001; r = 0.339,
p<0.001; sırasıyla)

Sonuç: Bu çalışmada ilk defa non-dipper HT ile SCORE risk
sistemi arasında önemli bir ilişki olduğu gösterilmiştir. SCORE risk sistemi
ile hesaplanan 10 yıllık fatal KV olay ihtimalinin non-dipper hasta grubunda daha yüksek
saptanması, esansiyel HT tanılı hastaların AKBİ ile takibinin önemini ortaya
çıkarmıştır.

Keywords

Ambulatuar kan basıncı izleme; non-dipper hipertansiyon; SCORE risk sistemi; kardiyovasküler hastalık.

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