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6. Potential utility of ambulatory blood pressure monitoring in patients with congestive heart failure
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JPY
Abstract
Blood pressures and heart rates are characterized by circadian changes. However, whether ambulatory blood pressure monitoring can have a useful role in the management of heart failure remains unclear. We studied 6 inpatients with New York Heart Association functional class I or II congestive heart failure (CHF). The subjects underwent 24–hour ambulatory blood pressure moni- toring (ABPM), Holter electrocardiographic (ECG) monitoring, echocardiography, and endocri- nologic evaluations. There were no significant differences between daytime and nighttime systolic or diastolic blood pressures or heart rate. Multivariate linear regression analyses showed that the plasma BNP concentration negatively correlated with nighttime heart rate, daytime blood pres- sure, and ejection fraction, but positively correlated with the plasma noradrenaline concentration. Our results suggest that a reduction in BNP levels might require the maintenance of higher nighttime heart rates and daytime blood pressures in patients with CHF. Chrono–cardiovascular approaches may thus be useful for the management of CHF.
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