Clinical and functional assessment of daily blood pressure variations in patients with pneumonia

Aim. To define the specific features of daily blood pressure (BP) variations in patients with extrahospital pneumonia (EHP) that has developed in the presence of baseline normotension and arterial hypertension (AH).
Material and methods. 83 patients aged 18 to 80 years who had EHP of varying severity were examined. Mild and moderate systolic and diastolic AH preceding EHP had occurred in 28 elderly patients. At the peak of the disease and before discharge, the patients underwent 24-hour BP monitoring with a portable ABPM-03 monitor ("Meditech", Hungary).
Results. At the peak of mild and moderate EHP, young patients had predominantly a normotensive daily BP curve whereas old patients with baseline normotension had systolic overload of target organs and a greater BP variability. At the peak of severe EHP, the normotensive patients had, irrespective of their age, systolic and diastolic arterial hypotension with a marked hypotensive overload and a low BP variability. In elderly patients with mild and moderate AH, non-severe EHP provoked negative changes in the daily ВР profile (DBPP), which are indicative of an exacerbation of the disease as isolated systolic or systolic-and-diastolic AH, a greater BP variability, high values and rates of its morning elevation. At the peak of severe EHP, hypertensive old patients showed DBPP variations as two types: moderate systolic-and-diastolic hypotension or the unchanged hypertensive profile of a daily BP curve. Conclusion. Analyzing DBPP in patients with EHP has indicated that the nature and degree of its impairments at the peak of the disease are determined by three independent factors: age, severity of the disease, and baseline BP values. The findings may provide rational therapy for AH in patients with EHP.

pneumonia, arterial hypertension, daily blood pressure monitoring, arterial hypotension