| D-dimer, factor VIII and von Willebrand factor predict a non-dipping pattern of blood pressure in hypertensive patients. | |
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MedLine Citation:
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PMID: 23001640 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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AIM: The aim of this study is to assess whether the haemostatic markers D-dimer, factor VIII (FVIII) and von Willebrand factor (VWF) are predictive of non-dipping status in treated hypertensive patients; so, as easy available laboratory data can predict non-dipping pattern and help with the selection of the patients whom circadian blood pressure should be re-examined. PATIENTS AND METHODS: Forty treated hypertensive patients with essential hypertension were included in the study. Twenty-four-hour ambulatory blood pressure monitoring was performed in all patients. Daytime and nocturnal average systolic, diastolic and mean blood pressures were calculated. Patients were characterised as "non-dippers" on the basis of a less than 10 % decline in nocturnal blood pressure (BP); either systolic or diastolic or mean (MAP). D-dimer as marker of fibrinolytic function, FVIII activity and VWF antigen as marker of endothelial dysfunction were measured on plasma. The predictive efficiency was analysed by receiver operating characteristic (ROC) curves. Youden index was used for the estimation of the cut-off points and the associated values for sensitivity and 1-specificity. RESULTS: Plasma levels of D-dimer, FVIII and VWF were significantly higher in non-dippers as compared with dippers, irrespective of the classification used (BP index); all P < 0.05. The ROC curves indicated a good diagnostic efficiency for D-dimer (AUC(ROC) = 0.697, 0.715 and 0.774), FVIII (AUC(ROC) = 0.714, 0.692 and 0.755) and VWF (AUC(ROC) = 0.706, 0.740 and 0.708) in distinguishing non-dipping pattern (systolic, diastolic or mean) in the study population; all P < 0.05. Among the three haemostatic markers, D-dimer presents the most satisfactory sensitivity/1-specificity for the differentiation of non-dippers, with a cut-off point >168 ng/ml (sensitivity/1-specificity for systolic BP non-dippers of 0.789/0.381, for diastolic BP non-dippers 0.923/0.444 and for MAP non-dippers 0.875/0.375). CONCLUSION: In conclusion, D-dimer has a good predictive value for non-dipping pattern and the decision for the 24-h ambulatory blood pressure re-monitoring among dippers could rely on its values. |
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Authors:
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Athanasia Agorasti; Theodoros Trivellas; Efthimia Mourvati; Vasilios Papadopoulos; Konstantinos Tsatalas; Vasilios Vargemezis; Ploumis Passadakis |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-9-23 |
Journal Detail:
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Title: International urology and nephrology Volume: - ISSN: 1573-2584 ISO Abbreviation: Int Urol Nephrol Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-9-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0262521 Medline TA: Int Urol Nephrol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Hematology Laboratory, General Hospital of Xanthi, Ephessou 68, 67100, Xanthi, Greece, vhrissan@civil.duth.gr. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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