Beyaz önlük hipertansiyonunda uç organ hasarı ile vücut kitle indeksi arasındaki ilişki

Yıl 2019, , 50 - 54, 29.01.2019

Atakan Demır , Mevlut Tamer Dıncer

https://doi.org/10.5472/marumj.518986

Öz

Amaç: Beyaz önlük hipertansiyonu (BÖH) poliklinik ölçümlerinde

kan basıncının yüksek bulunması ancak ambulatuvar kan basıncı

veya ev ölçümleri sırasında kan basınçlarının normal seyretmesidir.

Biz bu çalışmada, obezitenin uç organ hasarına etkisini ve vücut

kitle indeksi (VKİ) ile BÖH’ün neden olduğu uç organ hasarı

arasındaki ilişkiyi incelemeyi amaçladık.

Hastalar ve Yöntemler: Çalışmamıza polikliniğimize başka

nedenlerle başvuran veya hastalık saptanmayan sağlıklı kişiler

arasından hipertansiyon tanısı almamış ya da hipertansiyon

nedeniyle tedavi edilmemiş olan bireyler dâhil edildi. Gündüz

ölçüm değerleri kriter alınarak sistolik kan basıncı 135 mmHg,

diastolik kan basıncı 85 mmHg’nın altındaki değerler BÖH olarak

kabul edildi. Hastalar uç organ hasarı yönünden değerlendirildi.

Ekokardiografi ile sol ventrikül kitlesi (SVK) ölçüldü. Retinopati

araştırıldı. Mikroalbuminüri düzeyine bakıldı.

Bulgular: Ortalama sol ventrikül kitle indeksi (SVKİ) ve

SVK değerleri sırasıyla 96,29 ± 25,64 gr/m2 ve 170,87 ± 50,17

gr bulundu. Hipertansif retinopati sıklığı %17’idi. Kan basıncı

değerlerinden bağımsız olarak VKİ ile SVK ve SVKİ arasında

korelasyon bulundu.

Sonuç: Beyaz önlük hipertansiyonunun masumiyeti konusunda

çelişkili ifadeler vardır. Değişen kan basıncı değerlerinden bağımsız

olarak farklı uç organ hasarları görülmektedir. Obez olan BÖH

hastalarında kardiyak yetmezlik daha sık ve erken görülmektedir.

Sonuç olarak BÖH’lü bir hasta izlenirken kan basınçlarında

anlamlı değişiklik olmaksızın uç organ hasarı oluşabilmektedir.

Anahtar Kelimeler

Hipertansiyon, Vücut Kitle İndeksi, Kan basıncı

The relation between body mass index and end organ damage in white coat hypertension

Öz

Objective: White coat hypertension (WCH) is characterized by

blood pressure, which is high in the outpatient clinic and normal

either on ambulatory blood pressure (BP) monitoring or home

BP monitoring. In this study, our objective was to investigate the

effects of obesity on end organ damage and the correlation between

body mass index (BMI) and end organ damage caused by WCH.

Patients and Methods: Individuals, who applied to our

outpatient clinic due to other complaints or who were not diagnosed

with or treated for hypertension, were enrolled in our study. Based

on daytime values, systolic blood pressures below 135mmHg

and diastolic blood pressures below 85mmHg were considered as

WCH. The patients were examined for the findings of end organ

damage. The left ventricular mass (LVM) was measured with

echocardiography. Findings of hypertensive retinopathy were

evaluated and albumin levels were measured.

Results: The mean left ventricular mass index (LVMI) and

LVM values were 96.29±25.6g/m2 and 170.87±50.17g respectively.

The rate of hypertensive retinopathy was 17%. We determined

a significant correlation between BMI and LVMI independently

from blood pressure levels.

Conclusion: There are conflicting conclusions about the risks

related to WCH. However, several types of end organ damage

can be observed independently from the blood pressure levels in

this group of patients. Cardiac failure is more common and has

an early onset in obese patients with WCH. In conclusion, end

organ damage may emerge during the follow-up of WCH patients

without a significant change in the blood pressure values.

Anahtar Kelimeler

Hypertension, Body Mass Index, Blood Pressure

Kaynakça

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