MIGRAINE, HYPERTENSION, NON-DIPPING STATUS AND CARDIO-VASCULAR RISK ASSESSMENT: THE RESULTS OFAMBULATORY BLOOD PRESSURE MONITORING
Objectives: to evaluate the presence of non-dipping blood pressure (BP) status in patients with migraine and hypertension and establish the cardio-vascular risk.
Methods: The study group concern patients with migraine and hypertension (n=36). The patients underwent 24-h ambulatory blood pressure monitoring. Thenon-dipper, extreme dipper,and night piker (over dipper) status of blood pressure were defined as nocturnal decrease (dip) in systolic BP less than 10%, more than 20% and elevation of BP, as compared to the daytime BP, respectively. For 10 patients was calculated cardio-vascular risk using SCORE risk chart, 19 patient performed imagistic evaluations (CT or MRI) for silent white matter lesions.Data were analyzed with Epi Info package for Windows.
Results: Mean age 49.53 ± 10.61. Migraine was chronic in 21p (70%). The headache started at 22.16±5.25 age and hypertension at 45.82±8.1 age. The mean duration of migraine was 25.5±11.0 years and of hypertension 6.94±6.35 age. Mean blood pressure levels were: systolic 129 ± 10.86 mmHg for daytime and 118.9 ±12.03mmHg for nighttime and diastolic 81.8 ± 8.96 mmHg and 71.6 ± 9.10 respectively. According to circadian variation of blood pressure 44% (n-16) was dipper, 41% (n=15) non-dipper and 11% (n=4) over dipper. The mean daytime blood pressure levels were above the thresholds in 40% of the patients and nighttime levels in 70% of the patients. In the group withCT/MRI 27% (n=10) presented silent white matter lesions and 24.3% (n=9) not. According to SCORE evaluation the risk for 10 years for fatal cardio and cerebro-vascular event was high: 1% (2p), 2% (4p), 3-4% (3p), 5-9% (1p).
Conclusion: Migraine, hypertension and non-dipper status are cardiovascular and cerebro-vascular risk factors that could be evaluated using blood pressure monitoring. When found in the same patient they influence each other and increase risk for cardiovascular events and silent white matter lesion.