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Autonomic dysfunction in COVID-19 patients receiving mechanical ventilation: A cross-sectional study COVID19 COVID 19 COVID-1 ventilation crosssectional cross sectional COVID1 1 COVID-
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Silva, Renata Baltar da

; Neves, Victor Ribeiro

; Barros, Mayara Costa

; Gambassi, Bruno Bavaresco

; Schwingel, Paulo Adriano

; Sobral Filho, Dário Celestino

Sao Paulo Medical Journal

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2023, Volume 141 N. 6 elocation e2022513

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Coronavirus disease 2019 (COVID-19) can damage cardiac tissue by increasing troponin levels and inducing arrhythmias, myocarditis, and acute coronary syndrome. OBJECTIVES: To analyze the impact of COVID-19 on cardiac autonomic control in mechanically ventilated intensive care unit (ICU) patients. DESIGN AND SETTING: This cross-sectional analytical study of ICU patients of both sexes receiving mechanical ventilation was conducted in a tertiary hospital. METHODS: Patients were divided into COVID-19-positive (COVID(+)) and COVID-19-negative (COVID(-)) groups. Clinical data were collected and heart rate variability (HRV) records obtained using a heart rate monitor. RESULTS: The study sample comprised 82 subjects: 36 (44%) in the COVID(-) group (58.3% female; median age, 64.5 years) and 46 (56%) in the COVID(+) group (39.1% females; median age, 57.5 years). The HRV indices were lower than the reference values. An intergroup comparison identified no statistically significant differences in the mean normal-to-normal (NN) interval, standard deviation of the NN interval, or root mean square of successive differences in NN intervals. The COVID(+) group had an increased low frequency (P = 0.05), reduced high frequency (P = 0.045), and increased low frequency/high frequency (LF/HF) ratio (P = 0.048). There was a weak positive correlation between LF/HF and length of stay in the COVID(+) group. CONCLUSION: Patients who received mechanical ventilation had lower overall HRV indices. COVID(+) patients who received mechanical ventilation had lower vagal HRV components. These findings likely indicate clinical applicability, as autonomic control impairments are associated with a greater risk of cardiac death. BACKGROUND 201 COVID19 COVID 19 (COVID-19 arrhythmias myocarditis syndrome OBJECTIVES COVID-1 (ICU SETTING crosssectional cross sectional hospital METHODS COVID19positive COVIDpositive COVID+ + (COVID(+) COVID19negative COVIDnegative negative (COVID(-) groups (HRV monitor RESULTS 8 subjects 3 44% 44 (44% COVID(- 58.3% 583 58 (58.3 female age 645 64 5 64. years 4 56% 56 (56% COVID(+ 39.1% 391 39 1 (39.1 females 575 57 57. years. . values normaltonormal normal to (NN interval intervals P 0.05, 005 0.05 , 0 05 0.05) 0.045, 0045 0.045 045 0.045) frequencyhigh LFHF LF HF (LF/HF 0.048. 0048 0.048 048 0.048) CONCLUSION components applicability death 20 COVID1 (COVID-1 COVID- (COVID(+ (COVID(- (44 COVID( 58.3 (58. 6 (56 39.1 (39. 00 0.0 004 0.04 04 2 (COVID- (COVID( (4 58. (58 (5 39. (39 0. (COVID ( (3

https://doi.org/10.1590/1516-3180.2022.0513.r1.09022023

Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023 202 20 2
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Marin-Neto, José Antonio

; Rassi Jr, Anis

; Oliveira, Gláucia Maria Moraes

; Correia, Luís Claudio Lemos

; Ramos Júnior, Alberto Novaes

; Luquetti, Alejandro Ostermayer

; Hasslocher-Moreno, Alejandro Marcel

; Sousa, Andréa Silvestre de

; Paola, Angelo Amato Vincenzo de

; Sousa, Antônio Carlos Sobral

; Ribeiro, Antonio Luiz Pinho

; Correia Filho, Dalmo

; Souza, Dilma do Socorro Moraes de

; Cunha-Neto, Edecio

; Ramires, Felix Jose Alvarez

; Bacal, Fernando

; Nunes, Maria do Carmo Pereira

; Martinelli Filho, Martino

; Scanavacca, Maurício Ibrahim

; Saraiva, Roberto Magalhães

; Oliveira Júnior, Wilson Alves de

; Lorga-Filho, Adalberto Menezes

; Guimarães, Adriana de Jesus Benevides de Almeida

; Braga, Adriana Lopes Latado

; Oliveira, Adriana Sarmento de

; Sarabanda, Alvaro Valentim Lima

; Pinto, Ana Yecê das Neves

; Carmo, Andre Assis Lopes do

; Schmidt, Andre

; Costa, Andréa Rodrigues da

; Ianni, Barbara Maria

; Markman Filho, Brivaldo

; Rochitte, Carlos Eduardo

; Macêdo, Carolina Thé

; Mady, Charles

; Chevillard, Christophe

; Virgens, Cláudio Marcelo Bittencourt das

; Castro, Cleudson Nery de

; Britto, Constança Felicia De Paoli de Carvalho

; Pisani, Cristiano

; Rassi, Daniela do Carmo

; Sobral Filho, Dário Celestino

; Almeida, Dirceu Rodrigues de

; Bocchi, Edimar Alcides

; Mesquita, Evandro Tinoco

; Mendes, Fernanda de Souza Nogueira Sardinha

; Gondim, Francisca Tatiana Pereira

; Silva, Gilberto Marcelo Sperandio da

; Peixoto, Giselle de Lima

; Lima, Gustavo Glotz de

; Veloso, Henrique Horta

; Moreira, Henrique Turin

; Lopes, Hugo Bellotti

; Pinto, Ibraim Masciarelli Francisco

; Ferreira, João Marcos Bemfica Barbosa

; Nunes, João Paulo Silva

; Barreto-Filho, José Augusto Soares

; Saraiva, José Francisco Kerr

; Lannes-Vieira, Joseli

; Oliveira, Joselina Luzia Menezes

; Armaganijan, Luciana Vidal

; Martins, Luiz Cláudio

; Sangenis, Luiz Henrique Conde

; Barbosa, Marco Paulo Tomaz

; Almeida-Santos, Marcos Antonio

; Simões, Marcos Vinicius

; Yasuda, Maria Aparecida Shikanai

; Moreira, Maria da Consolação Vieira

; Higuchi, Maria de Lourdes

; Monteiro, Maria Rita de Cassia Costa

; Mediano, Mauro Felippe Felix

; Lima, Mayara Maia

; Oliveira, Maykon Tavares de

; Romano, Minna Moreira Dias

; Araujo, Nadjar Nitz Silva Lociks de

; Medeiros, Paulo de Tarso Jorge

; Alves, Renato Vieira

; Teixeira, Ricardo Alkmim

; Pedrosa, Roberto Coury

; Aras Junior, Roque

; Torres, Rosalia Morais

; Povoa, Rui Manoel dos Santos

; Rassi, Sergio Gabriel

; Alves, Silvia Marinho Martins

; Tavares, Suelene Brito do Nascimento

; Palmeira, Swamy Lima

; Silva Júnior, Telêmaco Luiz da

; Rodrigues, Thiago da Rocha

; Madrini Junior, Vagner

; Brant, Veruska Maia da Costa

; Dutra, Walderez Ornelas

; Dias, João Carlos Pinto

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 6 elocation e20230269

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.36660/abc.20230269

Heart rate turbulence assessed through ergometry after myocardial infarction: a feasibility study
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Gomes, Rafael Alessandro Ferreira

; Sobral-Filho, Dário Celestino

Sao Paulo Medical Journal

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dec 2022, Volume 140 N. 6 Pages 762 - 766

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Coronary artery disease is an important cause of morbidity and mortality. The impact of ventricular arrhythmias with impaired cardiac vagal activity is one of the most recently studied prognostic factors. However, there are no studies evaluating the phenomenon of heart rate turbulence (HRT) during physical exertion. OBJECTIVE: To study the behavior of HRT during exercise testing, among individuals after myocardial infarction. DESIGN AND SETTING: Feasibility study conducted in a university hospital among individuals 4-6 weeks after myocardial infarction. METHODS: All subjects underwent 24-hour Holter monitoring and ergometric stress testing. We considered that abnormal HRT was present if the turbulence onset was ≥ 0% or turbulence slope was ≤ 2.5 mm/relative risk interval. RESULTS: All 32 subjects were asymptomatic. Their median age was 58 years (interquartile range 12.8) and 70% were male. Abnormal HRT was associated with ventricular dysfunction in this population. We found no differences regarding the behavior of HRT, in relation to age, gender, smoking, systemic arterial hypertension, diabetes mellitus or dyslipidemia. Ergometric stress testing detected premature ventricular beats (PVB) in approximately 44% of the examinations, and these occurred both during the active phase of effort and in the recovery period. The low occurrence of several isolated PVB in beta-blocked subjects made it difficult to perform statistical analysis to correlate HRT between ergometric and Holter testing. CONCLUSION: The data obtained in this study do not support performing HRT through ergometric stress testing among patients who remain on beta-blockers post-myocardial infarction, for the purpose of assessing cardiac vagal activity.

https://doi.org/10.1590/1516-3180.2021.0884.r1.27012022

Detection of atrial fibrosis using echocardiographic strain: a new pathway
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Silveira, Maria Mariana Barros Melo da

; Cabral, João Victor Batista

; Xavier, Amanda Tavares

; Costa, Lucas Reis da

; Nascimento, Dhouglas José Ferreira do

; Castillo, José Maria Del

; Vasconcelos, Luydson Richardson da Silva

; Sobral Filho, Dário Celestino

; Oliveira, Dinaldo Cavalcanti de

Revista da Associação Médica Brasileira

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jun 2022, Volume 68 N. 6 Pages 866 - 870

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1806-9282.20211244

Orthostatic changes in blood pressure and survival in elderly cardiopaths
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Chaves, Laura Mariana de Siqueira Mendonça

; Cabral, João Victor Batista

; Silveira, Maria Mariana Barros Melo da

; Silva, Márcia Cristina Amélia da

; Souza, Analú Corrêa de

; Oliveira, Dinaldo Cavalcanti de

; Sobral Filho, Dário Celestino

; Montarroyos, Ulisses Ramos

Revista da Associação Médica Brasileira

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jan 2022, Volume 68 N. 1 Pages 19 - 23

Abstract: En | Text: En | PDF: En

SUMMARY OBJECTIVE: The objective of this study was to analyze the association between orthostatic changes in blood pressure and mortality in elderly cardiopath patients. METHODS: A cohort of 455 elderly cardiopath patients, monitored at a referral outpatient cardiology clinic in Pernambuco, Brazil, from October 2015 to July 2018. The exposure groups were formed according to their orthostatic changes in blood pressure following the requirements of the Brazilian Guidelines for Hypertension. RESULTS: Orthostatic hypotension was present in 46 patients (10.1%), 91 had orthostatic hypertension (20%), and 318 had no orthostatic alterations (69.9%). There were 52 deaths during follow-up. The results demonstrated that there was no statistically significant association between orthostatic hypotension and overall mortality (HR 1.30; 95%CI 0.53–3.14; p=0.567) nor between orthostatic hypertension and overall mortality (HR 0.95; 95%CI 0.65–1.39; p=0.34). Survival in relation to the exposure groups presented no statistically significant difference (p=0.504). CONCLUSION: There was a low frequency of orthostatic hypotension and a mild high frequency of orthostatic hypertension when compared with previous studies, and no association was observed with overall mortality or with the survival time of elderly patients with heart disease.

https://doi.org/10.1590/1806-9282.20210199

Beautiful death: point of view
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Oliveira, Dinaldo Cavalcanti de

; Cabral, João Victor Batista

; Silveira, Maria Mariana Barros Melo da

; Oliveira, Carolina Gomes Cavalcanti de

; Sobral Filho, Dário Celestino

Revista da Associação Médica Brasileira

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apr 2021, Volume 67 N. 4 Pages 481 - 484

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1806-9282.20200999 33 downloads

Triggering receptor expressed on myeloid cells-1 as pediatric sepsis biomarker
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Cabral, João Victor

; Silveira, Maria Mariana Barros Melo da

; Xavier, Amanda Tavares

; Assunção, Norma de

; Sobral Filho, Dário Celestino

; Oliveira, Dinaldo Cavalcanti de

Revista da Associação Médica Brasileira

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mar 2021, Volume 67 N. 3 Pages 449 - 453

Abstract: En | Text: En | PDF: En

SUMMARY OBJECTIVE: Triggering receptor expressed on myeloid cells-1 concentration can be used as a predictive, diagnostic, and prognostic marker in patients with sepsis. The objective of this study was to determine the validity of triggering receptor expressed on myeloid cells-1 levels as a biomarker of sepsis in pediatric patients. METHODS: This was an integrative literature review. PubMed, ScienceDirect, LILACS, MEDLINE, and VHL databases were searched for papers published between 2015 and 2020, using the keywords triggering receptor expressed on myeloid cells-1, sepsis, and child. RESULTS: The review included ten studies, of which four used triggering receptor expressed on myeloid cells-1 as a predictive biomarker; four, as a diagnostic biomarker; and two, as a prognostic biomarker. A total of 1,409 and 1,628 patients were included in primary and review studies, respectively. There was a predominance of significant results for the validity of triggering receptor expressed on myeloid cells-1 levels in the prediction, diagnosis, and prognosis of sepsis in pediatric patients. CONCLUSIONS: Triggering receptor expressed on myeloid cells-1 is a valid predictive, diagnostic, and prognostic biomarker of sepsis with good sensitivity and specificity in the pediatric population.

https://doi.org/10.1590/1806-9282.20200765 48 downloads

Potential Role of Hematological Parameters in Patients with Acute Myocardial Infarction: viewpoint
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Monteiro Júnior, José Gildo de Moura

; Sobral Filho, Dário Celestino

International Journal of Cardiovascular Sciences

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oct 2020, Volume 33 N. 5 Pages 586 - 588

Abstract: En | Text: En | PDF: En

https://doi.org/10.36660/ijcs.20200108 342 downloads

Performance of a Hematological Scoring System in Predicting All-Cause Mortality in Patients with Acute Myocardial Infarction
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Monteiro Júnior, José Gildo de Moura

; Torres, Dilênia de Oliveira Cipriano

; Silva, Maria Cleide Freire Clementino da

; Príncipe, Tácio Rian Nogueira

; Vasconcelos, Rhayssa Barbosa de

; Brito, Maria Eduarda Cavalcanti de

; Limeira, Maria Alice Aquino

; Santos, Ana Célia Oliveira dos

; Montarroyos, Ulisses Ramos

; Sobral Filho, Dário Celestino

International Journal of Cardiovascular Sciences

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jul 2020, Volume 33 N. 4 Pages 380 - 388

Abstract: En | Text: En | PDF: En

Abstract Background: The presence of nucleated red blood cells (NRBCs) and increases in mean platelet volume (MPV) and neutrophil to lymphocyte ratio (NLR) in peripheral circulation are associated with poorer prognosis in patients with acute coronary disease. Objective: We developed a scoring system for in-hospital surveillance of all-cause mortality using hematological laboratory parameters in patients with acute myocardial infarction (AMI). Methods: Patients admitted for AMI were recruited in this prospective study. Exclusion criteria were age younger than 18 years, glucocorticoid therapy, cancer or hematological diseases and readmissions. NRBCs, MPV and NLR were measured during hospitalization. The scoring system was developed in three steps: first, the magnitude of the association of clinical and laboratory parameters with in-hospital mortality was measured by odds ratio (OR), second, a multivariate logistic regression model was conducted with all variables significantly (p < 0.05) associated with the outcome, and third, a β-coefficient was estimated by multivariate logistic regression with hematological parameters with a p < 0.05. Results: A total of 466 patients (mean age were 64.2 ± 12.8 years, 61.6% male) were included in this study. A hematological scoring system ranging from 0 to 49, where higher values were associated with higher risk of in-hospital death. The best performance was registered for a cut-off value of 26 with sensitivity of 89.1% and specificity of 67.2%, positive predictive value of 26.8% (95% CI: 0.204 - 0.332) and negative predictive value of 97.9% (95% CI: 0.962 - 0.996). The area under the curve for the scoring system was 0.868 (95% CI: 0.818 - 0.918). Conclusions: Here we propose a hematological scoring system for surveillance tool during hospitalization of patients with acute myocardial infarction. Based on total blood count parameters, the instrument can evaluate inflammation and hypoxemia due to in-hospital complications and, consequently, predict in-hospital mortality.

https://doi.org/10.36660/ijcs.20190094 276 downloads

10.

Mortality due to congenital heart disease in Pernambuco from 1996 to 2016
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Cabral, João Victor Batista

; Guimarães, Aline Luzia Sampaio

; Sobral Filho, Dário Celestino

; Santos, Ana Célia Oliveira dos

Revista da Associação Médica Brasileira

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jul 2020, Volume 66 N. 7 Pages 931 - 936

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO OBJETIVO Determinar a magnitude e tendência temporal dos óbitos por doenças cardiovasculares congênitas (DCC) em Pernambuco entre 1996 e 2016. MÉTODOS Trata-se de um estudo ecológico, de série temporal, com todos os casos de óbitos por doenças cardiovasculares congênitas no estado de Pernambuco, entre 1996 e 2016, por meio dos dados do Datasus, Sinasc e SIM. RESULTADOS Ocorreram 3.584 óbitos por DCC entre indivíduos de 0 a 14 anos de idade, dos quais 81,94% foram concentrados em crianças menores de 1 ano de idade. A taxa de mortalidade infantil apresentou tendência linear de crescimento de 0,4645 por ano (p<0,01). A causa Q24 (outras malformações congênitas do coração) esteve presente em 72,54% dos registros de óbitos e 48,17% dos óbitos ocorreram na faixa etária de 28 a 364 dias de vida. Maior ocorrência de óbitos foi identificada entre os nascidos com peso entre 500 e 1.499 g, do sexo masculino, pré-termos, filhos de mães sem escolaridade e em partos domiciliares (p<0,05). CONCLUSÕES As cardiopatias congênitas ainda representam um problema de saúde pública como causa de mortalidade, especialmente no primeiro ano de vida. A taxa de mortalidade por DCC apresentou tendência linear de crescimento. As características gerais demonstraram significância estatística para óbitos entre crianças prematuras, com baixo peso, do sexo masculino, nascidas de mães sem escolaridade e em partos domiciliares.

SUMMARY BACKGROUND To determine the magnitude and temporal trends of deaths due to congenital heart disease (CHD) in Pernambuco between 1996 and 2016. METHODS This was an ecological, time-series study, involving all cases of deaths from congenital cardiovascular malformations in the state of Pernambuco, from 1996 to 2016, using data from DATASUS, SINASC and SIM. RESULTS There were 3,584 deaths from congenital cardiovascular malformations amongst individuals aged 0 to 14 years, of which 81.94% were concentrated in children aged under one year. The infant mortality rate (IMR) presented a linear growth trend of 0.4645 per year (p <0.01). The cause-of-death code Q24 (other congenital malformations of the heart) was present in 72.54% of the death records and 48.17% of the deaths occurred in infants aged between 28 and 364 days of life. The highest occurrence of deaths was identified in children with low birth weight (500 and 1,499g), male, premature, children of mothers without schooling, in deliveries at home (p <0.05). CONCLUSIONS Congenital heart disease still represents a public health problem as a cause of death, particularly in the first year of life, with IMR in a linear growth trend. Deaths from CHD were more prevalent in male children, born prematurely, with low birth weight, born to mothers with low schooling and deliveries without medical care.

https://doi.org/10.1590/1806-9282.66.7.931 667 downloads

11.

Demographic and clinical characteristics of pulmonary arterial hypertension caused by schistosomiasis are indistinguishable from other etiologies
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Mendes, Adriano Assis

; Roncal, Carlos Guilhermo Piscoya

; Oliveira, Flávio Roberto Azevedo de

; Albuquerque, Eugênio Soares de

; Góes, Gustavo Henrique Belarmino

; Piscoya, Isabelle Cecília de Vasconcellos

; Sobral Filho, Dário Celestino

Revista da Sociedade Brasileira de Medicina Tropical

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2020, Volume 53 elocation e20190418

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: Pulmonary arterial hypertension (PAH) is a serious pulmonary circulation disease caused by several etiologies, including schistosomiasis. The present study retrospectively evaluated the clinical and hemodynamic characteristics of patients with schistosomal PAH (PAH-Sch) compared to those of non-Sch PAH patients (non-Sch PAH). METHODS: Patients treated at the Pronto-Socorro Cardiológico de Pernambuco and diagnosed by right cardiac catheterization were divided into PAH-Sch and non-Sch PAH groups. Their socio-demographic and clinical characteristics, N-terminal-pro B-type natriuretic peptide (NT-proBNP), and echocardiography and hemodynamic parameters were retrospectively reviewed. RESULTS: Among the included 98 patients (mean age, 45 ± 14 years; 68 women [69.4%]), we found 56 PAH-Sch and 42 non-Sch PAH. The age distribution was heterogeneous in the PAH-Sch group, with patients predominantly ranging from 50-59 (p <0.004). Dyspnea was the most common symptom, reported by 92 patients (93.8%), and commonly present for over two years prior to diagnosis. Clinical symptoms were similar in both groups, with no differences in functional class, pulmonary artery systolic pressure (p = 0.102), 6-minute walk test score (p = 0.234), NT-proBNP serum levels (p = 0.081), or hemodynamic parameters. CONCLUSIONS: Patients with PAH-Sch present clinical, laboratory, and hemodynamic profiles similar to those with PAH resulting from other etiologies of poor prognosis. PAH is an important manifestation of schistosomiasis in endemic regions that is often diagnosed late.

https://doi.org/10.1590/0037-8682-0418-2019 987 downloads

12.

Resistance exercise performed with repetitions until failure affects nocturnal blood pressure decreases in hypertensive women
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Correia, Marilia de Almeida

; Lima, Aluísio Henrique Rodrigues Andrade

; Cardoso-Junior, Crivaldo Gomes

; Rodrigues-da-Silva, Anderson José Melo

; Oliveira, Jacilene Guedes

; Cavalcante, Bruno Remígio

; Souza, Bruna Cadengue Coelho

; Macedo-Junior, Edson Magno

; Sobral-Filho, Dário Celestino

; Ritti-Dias, Raphael Mendes

Motricidade

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sep 2015, Volume 11 N. 3 Pages 148 - 157

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Estudos vêm demonstrando que o exercício de força reduz a pressão arterial para níveis abaixo dos valores de repouso, entretanto este não é um achado universal. O número de repetições do exercício parece influenciar essas respostas. Assim, o objetivo do estudo foi analisar os efeitos do exercício de força realizado com repetições até a falha concêntrica sobre a pressão arterial de 24 horas em mulheres hipertensas. Treze mulheres hipertensas foram submetidas a três sessões experimentais em ordem aleatória: controle (C), exercício de força até a falha concêntrica (FC) e exercício de força com repetições até a redução da cadência (RC). Antes e 24 horas após as sessões as variáveis cardiovasculares - descenso noturno, ascensão matutina e presença ou não de padrão dipper - foram avaliadas por meio de monitorização ambulatorial da pressão arterial. Nos períodos diurno e noturno, não houve diferença significativa entre os três grupos. Entretanto, após FC e C, menos sujeitos apresentaram padrão dipper da pressão arterial (46% e 38%, respectivamente) do que quando comparado aos grupos RC (77%), p=0.047. Como conclusão, o FC atenuou a o padrão dipper da pressão arterial noturna em mulheres hipertensas.

Studies have shown that resistance exercise reduces 24-hour blood pressure to levels below resting values, although this is not a universal finding. The number of repetitions has been shown to influence this response. Thus, the aim of the study was to analyze the effects of resistance exercise performed until failure (UF) on 24-hour blood pressure in hypertensive women. Thirteen hypertensive women underwent three experimental sessions in random order: UF, resistance exercise with repetitions before concentric failure (BF) and control (C). Prior to and up to 24 hours after the sessions, cardiovascular variables, as well as the nocturnal fall in blood pressure, the morning surge, and the presence or absence of a blood pressure dip pattern were established using an ambulatory blood pressure monitor. In both wakefulness and sleep there was no significant difference among the three groups. However, after UF and C fewer patients presented a dip in blood pressure (46% and 38%, respectively) compared BF (77%), p=0.047. In conclusion, the UF attenuated blood pressure dips at night in hypertensive patients.

https://doi.org/10.6063/motricidade.4706 1572 downloads

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