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de acordo com v&#225;rios estudos&#44; tem sido associado a mais les&#245;es de &#243;rg&#227;o&#44; nomeadamente hipertrofia ventricular esquerda&#44; microalbumin&#250;ria e les&#227;o renal&#44; dist&#250;rbios do sono&#44; bem como a pior progn&#243;stico cardiovascular&#44; com maior risco para eventos cardio e cerebrovasculares<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#8211;6</span></a>&#46; O perfil <span class="elsevierStyleItalic">extreme dipper</span> tamb&#233;m tem demonstrado um papel importante no impacto progn&#243;stico cardiovascular<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A retinopatia hipertensiva &#40;RH&#41; &#233; a principal manifesta&#231;&#227;o ocular de hipertens&#227;o arterial &#40;HTA&#41;&#44; cerca de 50&#8208;80&#37; dos doentes &#40;dts&#41; hipertensos desenvolvem altera&#231;&#245;es na microvasculatura da retina<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a>&#46; Os sinais de RH parecem apresentar um papel importante como indicadores de risco no &#226;mbito de morbilidade e mortalidade cardiovascular<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">8</span></a>&#46; De acordo com alguns autores&#44; a avalia&#231;&#227;o da retina &#233; fundamental para a estratifica&#231;&#227;o do risco vascular<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">A rela&#231;&#227;o entre a varia&#231;&#227;o circadiana da PA e a preval&#234;ncia e gravidade da RH est&#225; ainda pouco esclarecida&#46; De acordo com alguns estudos&#44; a RH &#233; mais frequente e apresenta maior gravidade nos dts <span class="elsevierStyleItalic">non&#8208;dipper</span><a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">No presente estudo&#44; pretendemos avaliar em dts hipertensos a rela&#231;&#227;o entre os valores noturnos de pressurometria em ambulat&#243;rio de 24<span class="elsevierStyleHsp" style=""></span>h e preval&#234;ncia e a gravidade da RH&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Popula&#231;&#227;o e amostra</span><p id="par0035" class="elsevierStylePara elsevierViewall">A popula&#231;&#227;o foi constitu&#237;da por dts hipertensos que realizaram um MAPA no per&#237;odo de janeiro a dezembro de 2013&#46; Os dts foram contactados telefonicamente para a realiza&#231;&#227;o de uma fundoscopia no hospital&#44; com o intuito de avaliar les&#227;o de &#243;rg&#227;o&#8208;alvo&#46; Do total de 355 dts&#44; apenas 46 dts aceitaram realizar o exame&#44; constituindo estes a amostra do estudo&#59; os restantes recusaram ou apresentavam contactos telef&#243;nicos inv&#225;lidos&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Vari&#225;veis</span><p id="par0040" class="elsevierStylePara elsevierViewall">A amostra foi caracterizada de acordo com as suas caracter&#237;sticas basais &#40;idade e sexo&#41;&#59; cl&#237;nicas &#40;antecedentes pessoais&#47;comorbilidades e fatores de risco cardiovasculares&#59; dura&#231;&#227;o &#91;em anos&#93; de HTA&#59; HTA controlada&#41;&#59; laboratoriais &#40;n&#237;veis s&#233;ricos de creatinina&#41;&#59; altera&#231;&#245;es ecocardiogr&#225;ficas &#40;presen&#231;a de hipertrofia conc&#234;ntrica do ventr&#237;culo esquerdo&#41; e de acordo com a terap&#234;utica &#40;grupo de f&#225;rmaco anti&#8208;hipertensor&#41;&#46; Estas vari&#225;veis foram avaliadas a partir de um question&#225;rio entregue ao doente &#40;<a class="elsevierStyleCrossRef" href="#sec0115">Anexo I</a>&#41; e a partir da consulta do processo cl&#237;nico inform&#225;tico&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">No &#226;mbito da caracteriza&#231;&#227;o do perfil tensional foram determinados os valores de PA sist&#243;lica &#40;PAS&#41; e diast&#243;lica &#40;PAD&#41; m&#233;dias noturnas e diurnas&#44; e os dts classificados&#44; por sua vez&#44; de acordo com o perfil tensional noturno em <span class="elsevierStyleItalic">dipper</span> &#40;redu&#231;&#227;o da PA m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>10&#37; e<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>20&#37;&#41;&#44; <span class="elsevierStyleItalic">non&#8208;dipper</span> &#40;redu&#231;&#227;o da PA m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10&#37;&#41;&#44; <span class="elsevierStyleItalic">inverted&#8208;dipper &#40;</span>redu&#231;&#227;o da PA m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#37;&#41; e <span class="elsevierStyleItalic">extreme dipper</span> &#40;redu&#231;&#227;o da PA m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>20&#37;&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Diagn&#243;stico de retinopatia hipertensiva</span><p id="par0050" class="elsevierStylePara elsevierViewall">O diagn&#243;stico de RH foi estabelecido por fundoscopia e a gravidade foi definida utilizando a classifica&#231;&#227;o de Scheie&#44; que caracteriza a presen&#231;a de les&#245;es hipertensivas &#40;est&#225;dios 0&#8208;4&#41; e ateroscler&#243;ticas &#40;graus 0&#8208;4&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lise estat&#237;stica</span><p id="par0055" class="elsevierStylePara elsevierViewall">Para realizar a an&#225;lise estat&#237;stica utilizou&#8208;se o programa <span class="elsevierStyleItalic">IBM SPSS Statistics&#44; vers&#227;o 20</span> para <span class="elsevierStyleItalic">Windows 8&#46;</span> As vari&#225;veis cont&#237;nuas foram expressas em valor m&#233;dio<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>desvio padr&#227;o e comparadas com o teste <span class="elsevierStyleItalic">T&#8208;Student&#39;s</span>&#46; As vari&#225;veis categ&#243;ricas foram expressas em valor absoluto e&#47;ou percentagem e comparadas com o teste quiquadrado&#46; As associa&#231;&#245;es foram consideradas estatisticamente significativas na presen&#231;a de <span class="elsevierStyleItalic">p&#8208;value</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Resultados</span><p id="par0060" class="elsevierStylePara elsevierViewall">Estudaram&#8208;se 46 dts&#59; 46&#37; do sexo masculino &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41;&#44; com idade m&#233;dia 63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12 anos&#46; A presen&#231;a de RH foi observada em 83&#37; dos dts&#44; dos quais 64&#37; apresentavam&#44; de acordo com a classifica&#231;&#227;o de Scheie&#44; um est&#225;dio<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2 &#40;<a class="elsevierStyleCrossRefs" href="#tbl0010">Tabelas 2 e 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Quarenta e dois dts &#40;91&#37;&#41; estavam sob terap&#234;utica anti&#8208;hipertensora&#44; sendo os grupos farmacol&#243;gicos mais frequentes os betabloqueantes em 50&#37; e os diur&#233;ticos em 44&#37; dos dts&#59; posteriormente&#44; os IECA&#44; ARA e antagonistas dos canais de c&#225;lcio numa percentagem id&#234;ntica&#44; 39&#37; cada&#46; Com a terap&#234;utica institu&#237;da&#44; 30&#37; dos dts apresentava uma PA controlada &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Tabela 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">No &#226;mbito das comorbilidades e fatores de risco&#44; a dislipidemia e a diabetes <span class="elsevierStyleItalic">mellitus</span> foram as mais frequentes&#44; respetivamente em 91 e 35&#37;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">O perfil <span class="elsevierStyleItalic">non&#8208;dipper</span> foi observado em 37&#37; dos dts&#59; por sua vez&#44; o <span class="elsevierStyleItalic">dipper</span> em 48&#37;&#44; <span class="elsevierStyleItalic">extreme dipper</span> em 7&#37; e&#44; por fim&#44; o <span class="elsevierStyleItalic">inverted&#8208;dipper</span> em 9&#37;&#46; Os valores m&#233;dios de PAS e PAD noturnas foram&#44; respetivamente&#44; de 148<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23 e 66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9<span class="elsevierStyleHsp" style=""></span>mmHg &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Tabela 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Os n&#237;veis m&#233;dios de creatinina foram 1&#44;07<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7<span class="elsevierStyleHsp" style=""></span>mg&#47;dl na amostra e&#44; por sua vez&#44; 1&#44;12<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>07 nos dts com RH&#46; Cinquenta e tr&#234;s por centro dos dts apresentavam crit&#233;rios ecocardiogr&#225;ficos de hipertrofia ventricular esquerda &#40;HVE&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Tabela 5</a>&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discuss&#227;o</span><p id="par0085" class="elsevierStylePara elsevierViewall">A RH apresentou uma elevada preval&#234;ncia na nossa popula&#231;&#227;o &#40;83&#37;&#41;&#44; o que vai em concord&#226;ncia com a bibliografia&#44; sendo que altera&#231;&#245;es na microvasculatura da retina desenvolvem&#8208;se em 50&#8208;80&#37; dos dts hipertensos<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">A idade avan&#231;ada &#40;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9 anos&#41; e maior tempo de evolu&#231;&#227;o da hipertens&#227;o &#40;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12 anos&#41; foram associados a maior risco de retinopatia&#44; com significado estat&#237;stico&#46; Por sua vez&#44; o g&#233;nero bem como os antecedentes pessoais n&#227;o estiveram associados a maior risco de retinopatia&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Na teoria&#44; dts sob terap&#234;utica com HTA controlada apresentam menor risco de les&#245;es de &#243;rg&#227;o&#8208;alvo&#44; ou&#44; pelo menos&#44; uma evolu&#231;&#227;o mais lenta e progressiva&#44; contudo nesta popula&#231;&#227;o n&#227;o se conseguiu estabelecer essa associa&#231;&#227;o&#46; Apenas 38&#37; dos dts com HTA controlada n&#227;o apresentou qualquer les&#227;o microvascular da retina &#40;HTA n&#227;o controlada &#8211; 85&#37; &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>28&#93; RH <span class="elsevierStyleItalic">versus</span> 15&#37; &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#93; sem RH&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>ns&#59; HTA controlada &#8211; 77&#37; &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#93; RH <span class="elsevierStyleItalic">versus</span> 23&#37; &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#93; sem RH&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>ns&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">N&#237;veis m&#233;dios de creatinina elevados estiveram associados &#224; presen&#231;a de RH&#59; por sua vez&#44; com a hipertrofia do ventr&#237;culo esquerdo n&#227;o se conseguiu estabelecer essa associa&#231;&#227;o&#46; De acordo com a bibliografia&#44; as les&#245;es de &#243;rg&#227;o associadas &#224; hipertens&#227;o s&#227;o mais frequentes e precoces ao n&#237;vel do cora&#231;&#227;o &#40;HVE&#59; disfun&#231;&#227;o diast&#243;lica&#41; do que na retina e no rim&#59; eventualmente&#44; n&#227;o se conseguiu estabelecer uma associa&#231;&#227;o entre HVE e retinopatia&#44; pela reduzida dimens&#227;o da amostra<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">N&#227;o existiu qualquer diferen&#231;a estat&#237;stica entre a presen&#231;a de retinopatia e a classe do f&#225;rmaco anti&#8208;hipertensor&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">De acordo com v&#225;rios estudos&#44; os perfis <span class="elsevierStyleItalic">non&#8208;dipper</span> e <span class="elsevierStyleItalic">extreme dipper</span> est&#227;o associados a mais les&#245;es de &#243;rg&#227;o&#8208;alvo e a um importante impacto cardiovascular&#46; No &#226;mbito das les&#245;es da retina&#44; os estudos s&#227;o muito escassos&#44; contudo tem&#8208;se observado que essas les&#245;es s&#227;o mais frequentes e com maior gravidade nos dts <span class="elsevierStyleItalic">non&#8208;dipper</span><a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#8211;6</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Nenhum perfil tensional noturno esteve associado a maior risco de retinopatia&#44; apesar da elevada preval&#234;ncia dos perfis <span class="elsevierStyleItalic">dipper</span> e <span class="elsevierStyleItalic">non&#8208;dipper</span> nos dts com RH&#44; respetivamente 47 e 39&#37;&#44; contudo sem significado estat&#237;stico&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Por sua vez&#44; valores elevados de PAS noturna e diurna &#40;PAS noturna &#8211; RH 151<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23 <span class="elsevierStyleItalic">versus</span> sem RH 130<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13<span class="elsevierStyleHsp" style=""></span>mmHg&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#59; PAS diurna &#8211; RH 139<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14 <span class="elsevierStyleItalic">versus</span> 129<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8<span class="elsevierStyleHsp" style=""></span>mmHg&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41; foram associados &#224; presen&#231;a de retinopatia&#46; A gravidade da retinopatia foi observada em valores de PAS noturna elevados &#40;PAS noturna &#8211; RH est&#225;dio<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2153<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25 <span class="elsevierStyleItalic">versus</span> RH sem gravidade 140<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16<span class="elsevierStyleHsp" style=""></span>mmHg&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#46; Nos dts hipertensos&#44; a PAS demonstrou maior influ&#234;ncia do que a PAD no impacto negativo ao n&#237;vel da microvasculatura da retina&#46; Estudos observacionais t&#234;m demonstrado que a PAS &#233; um importante e independente preditor de risco para doen&#231;a cardiovascular e renal<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a>&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Limita&#231;&#245;es</span><p id="par0125" class="elsevierStylePara elsevierViewall">A reduzida dimens&#227;o da amostra constituiu uma das principais limita&#231;&#245;es do estudo&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclus&#227;o</span><p id="par0130" class="elsevierStylePara elsevierViewall">A RH apresentou uma elevada preval&#234;ncia na amostra em estudo&#44; sendo associada &#224; idade avan&#231;ada e a maior tempo de evolu&#231;&#227;o da hipertens&#227;o&#46; N&#227;o se verificou uma rela&#231;&#227;o entre um perfil tensional noturno e a presen&#231;a e&#47;ou gravidade da RH&#46; N&#237;veis mais elevados de PAS noturna estiveram associados a uma maior preval&#234;ncia e gravidade de retinopatia&#46; Apesar da reduzida amostra&#44; a PAS foi associada a maior risco de les&#227;o microvascular da retina&#44; quando comparada com a PAD&#46; Tendo em conta a elevada preval&#234;ncia da retinopatia na popula&#231;&#227;o de dts hipertensos e pelo impacto negativo do ponto de vistas cardiovascular&#44; que tem sido evidenciado em v&#225;rios estudos&#44; a avalia&#231;&#227;o da retina deve fazer parte do exame f&#237;sico de um doente hipertenso e a terap&#234;utica dirigida preferencialmente &#224; corre&#231;&#227;o da PAS&#46; De qualquer modo&#44; s&#227;o necess&#225;rios mais estudos com amostras bem dimensionadas para evidenciar uma rela&#231;&#227;o entre um perfil tensional e a retinopatia&#44; bem como para um correto ajuste terap&#234;utico&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflito de interesses</span><p id="par0135" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesses&#46;</p></span></span>"
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        10 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Conflito de interesses"
        ]
        11 => array:1 [
          "titulo" => "Bibliografia"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2017-02-12"
    "fechaAceptado" => "2017-06-29"
    "PalabrasClave" => array:2 [
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras&#8208;chave"
          "identificador" => "xpalclavsec963281"
          "palabras" => array:3 [
            0 => "Perfil dipper"
            1 => "MAPA"
            2 => "Retinopatia hipertensiva"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec963282"
          "palabras" => array:3 [
            0 => "Dipper profile"
            1 => "Ambulatory blood pressure monitoring"
            2 => "Hypertensive retinopathy"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Os perfis tensionais noturnos <span class="elsevierStyleItalic">non&#8208;dipper</span> e <span class="elsevierStyleItalic">extreme</span>&#8208;<span class="elsevierStyleItalic">dipper</span> t&#234;m sido associados a les&#245;es de &#243;rg&#227;o&#8208;alvo&#46; A rela&#231;&#227;o entre a press&#227;o arterial &#40;PA&#41; e retinopatia hipertensiva &#40;RH&#41; est&#225; pouco esclarecida&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Avaliar em doentes &#40;dts&#41; hipertensos a rela&#231;&#227;o entre os valores noturnos de pressurometria em ambulat&#243;rio de 24<span class="elsevierStyleHsp" style=""></span>h &#40;MAPA&#41; e preval&#234;ncia e a gravidade da RH&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Foram avaliados prospectivamente dts hipertensos submetidos &#224; realiza&#231;&#227;o de MAPA de 24<span class="elsevierStyleHsp" style=""></span>h&#46; Foram determinadas caracter&#237;sticas basais&#44; PA sist&#243;lica &#40;PAS&#41; e diast&#243;lica &#40;PAD&#41; m&#233;dias noturnas&#44; e os dts classificados pelo perfil tensional noturno em <span class="elsevierStyleItalic">dipper&#59; non&#8208;dipper&#59; inverted&#8208;dipper</span> e <span class="elsevierStyleItalic">extreme&#8208;dipper&#46;</span> O diagn&#243;stico de RH foi estabelecido por fundoscopia e a gravidade definida pela classifica&#231;&#227;o de Scheie&#46; Foi estabelecida a rela&#231;&#227;o entre valores de PAS e PAD noturnos e o perfil tensional noturno com a preval&#234;ncia e gravidade da RH&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Foram avaliados 46 dts &#40;46&#37; sexo masculino &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#93;&#59; idade m&#233;dia 63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12 anos&#41;&#46; Noventa e um por cento dos dts estavam sob terap&#234;utica anti&#8208;hipertensora &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#41;&#59; destes&#44; 30&#37; apresentavam PA controlada &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41;&#46; A presen&#231;a de RH foi observada em 83&#37; dos dts &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41;&#46; Os dts com RH apresentaram n&#237;veis de PAS noturna mais elevados &#40;151<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23 <span class="elsevierStyleItalic">versus</span> 130<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#41;&#46; A PAS noturna esteve ainda associada a uma maior gravidade de RH &#40;153<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25 <span class="elsevierStyleItalic">versus</span> 140<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#46; N&#227;o existiu rela&#231;&#227;o entre a PAD noturna ou o perfil tensional noturno e presen&#231;a de RH&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclus&#227;o</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">N&#237;veis mais elevados de PAS noturna estiveram associados a RH&#46; N&#227;o se verificou rela&#231;&#227;o entre o perfil tensional noturno e a presen&#231;a de RH&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introdu&#231;&#227;o"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objetivo"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "M&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclus&#227;o"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Non&#8208;dipper and extreme dipper blood pressure &#40;BP&#41; profiles are associated with a worse cardiovascular prognosis&#46; The relationship between nocturnal BP profile and hypertensive retinopathy &#40;HR&#41; is not fully established&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Aim</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">To assess the association between the prevalence and severity of HR and nocturnal BP&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">We prospectively studied hypertensive patients who underwent 24&#8208;hour ambulatory BP monitoring&#46; The population was divided into two groups according to the presence or absence of lesions and compared according to baseline characteristics&#44; nocturnal BP profile &#40;dippers&#44; non&#8208;dippers&#44; inverted dippers&#47;risers and extreme dippers&#41; and mean nocturnal systolic &#40;SBP&#41; and diastolic &#40;DBP&#41; BP values&#46; The presence and severity of HR were assessed using the Scheie classification&#46; The relationship between nocturnal SBP and DBP values &#40;and nocturnal BP profile&#41; and the prevalence and severity of HR was determined&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Forty&#8208;six patients &#40;46&#37; male&#44; aged 63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12 years&#41; were analyzed&#44; of whom 91&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#41; were under antihypertensive treatment&#46; Seventy percent &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#41; had uncontrolled BP&#46; HR was diagnosed in 83&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41;&#46; Patients with HR had higher mean systolic nocturnal BP &#40;151<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23 vs&#46; 130<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13 mmHg&#41;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#46; Patients with greater HR severity &#40;Scheie stage &#8805;<span class="elsevierStyleHsp" style=""></span>2&#41; had higher nocturnal BP &#40;153<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25 vs&#46; 140<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16 mmHg&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#46; There was no statistically significant association between DBP and nocturnal BP patterns and HR&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">The prevalence and severity of HR were associated with higher nocturnal SBP&#46; No relationship was observed between nocturnal BP profile and the presence of HR&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Aim"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Methods"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusions"
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          0 => array:4 [
            "apendice" => "<p id="par0250" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix B"
            "titulo" => "Material suplementario"
            "identificador" => "sec0110"
          ]
        ]
      ]
    ]
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                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Est&#225;dio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Altera&#231;&#245;es na fundoscopia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Diagn&#243;stico de HTA mas sem altera&#231;&#245;es vis&#237;veis na retina&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estreitamento arteriolar difuso&#46; Sem constri&#231;&#245;es focais&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estreitamento arteriolar mais pronunciado com constri&#231;&#245;es focais&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estreitamento difuso e focal&#46; Observa&#8208;se hemorragia da retina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Edema e exsudados da retina&#59; edema do disco &#243;tico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                0 => "xTab1697805.png"
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Classifica&#231;&#227;o de Scheie &#8211; les&#245;es hipertensivas</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Classifica&#231;&#227;o de Scheie<br>Est&#225;dio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Retinopatia hipertensiva<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;34&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;63&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Caracteriza&#231;&#227;o da gravidade da retinopatia hipertensiva</p>"
        ]
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Popula&#231;&#227;o<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Retinopatia hipertensiva<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sem RH<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p&#8208;value</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Caracter&#237;sticas basais</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Idade &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sexo masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;45&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;45&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Antecedentes pessoais</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes <span class="elsevierStyleItalic">mellitus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;34&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;37&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dislipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;91&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34 &#40;89&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DAP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;35&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;40&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Antecedentes EAM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Antecedentes de AVC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;17&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;18&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;13&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Evolu&#231;&#227;o da HTA</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dura&#231;&#227;o &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;027&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Carater&#237;sticas basais da popula&#231;&#227;o</p>"
        ]
      ]
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          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">A negrito&#44; os perfis tensionais que apresentaram diferen&#231;as estat&#237;stica entre a exist&#234;ncia e gravidade da RH&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Popula&#231;&#227;o<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Retinopatia hipertensiva<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sem RH<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p&#8208;value</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">RH sem gravidade<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">RH com gravidade &#40;est&#225;dio<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2&#41;<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p&#8208;value</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Dipper</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;47&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;46&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Extreme dipper</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Inverted&#8208;dipper</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;15&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Non&#8208;dipper</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;37&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;39&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;31&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;44&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PAS noturna &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">148</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">23</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">151</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">23</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">130</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">13</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">0&#44;008</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">140</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">16</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">153</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">25</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">0&#44;04</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PAD noturna &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PAS diurna &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">138</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">13&#44;4</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">139</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">14</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">129</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">8</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">0&#44;021</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">135<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">140<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PAD diurna &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        ]
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Artigo Original
Relação entre o perfil tensional noturno e a prevalência e gravidade da retinopatia hipertensiva
Relationship between nocturnal blood pressure profiles and the presence and severity of hypertensive retinopathy
Tatiana Duartea,
Autor para correspondência
tatiana.isabel.duarte@gmail.com

Autor para correspondência.
, Sara Gonçalvesa, Raquel Britob, Catarina Sáa, Rita Marinheiroa, Marta Fonsecaa, Rita Rodriguesa, Filipe Seixoa, Anabela Guerreiroa, Andreia Fernandesa, Cristina Carradasa, Isabel Silvestrea, Leonel Bernardinoa, Rui Cariaa
a Serviço de Cardiologia, Centro Hospitalar de Setúbal, Setúbal, Portugal
b Serviço de Oftalmologia, Centro Hospitalar de Setúbal, Setúbal, Portugal
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">A hipertens&#227;o arterial &#233; uma doen&#231;a frequente&#44; com uma preval&#234;ncia na popula&#231;&#227;o em geral de 30&#8208;45&#37;&#44; com um importante impacto na morbilidade e na mortalidade<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">V&#225;rios estudos t&#234;m demonstrado uma melhor correla&#231;&#227;o entre os valores da monitoriza&#231;&#227;o ambulat&#243;ria da press&#227;o arterial de 24<span class="elsevierStyleHsp" style=""></span>h &#40;MAPA&#41; com o grau de les&#227;o de &#243;rg&#227;os&#8208;alvo e com o progn&#243;stico cardiovascular global&#44; quando comparado com os valores ocasionais de press&#227;o arterial &#40;PA&#41;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">O perfil <span class="elsevierStyleItalic">non&#8208;dipper</span>&#44; de acordo com v&#225;rios estudos&#44; tem sido associado a mais les&#245;es de &#243;rg&#227;o&#44; nomeadamente hipertrofia ventricular esquerda&#44; microalbumin&#250;ria e les&#227;o renal&#44; dist&#250;rbios do sono&#44; bem como a pior progn&#243;stico cardiovascular&#44; com maior risco para eventos cardio e cerebrovasculares<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#8211;6</span></a>&#46; O perfil <span class="elsevierStyleItalic">extreme dipper</span> tamb&#233;m tem demonstrado um papel importante no impacto progn&#243;stico cardiovascular<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A retinopatia hipertensiva &#40;RH&#41; &#233; a principal manifesta&#231;&#227;o ocular de hipertens&#227;o arterial &#40;HTA&#41;&#44; cerca de 50&#8208;80&#37; dos doentes &#40;dts&#41; hipertensos desenvolvem altera&#231;&#245;es na microvasculatura da retina<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a>&#46; Os sinais de RH parecem apresentar um papel importante como indicadores de risco no &#226;mbito de morbilidade e mortalidade cardiovascular<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">8</span></a>&#46; De acordo com alguns autores&#44; a avalia&#231;&#227;o da retina &#233; fundamental para a estratifica&#231;&#227;o do risco vascular<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">A rela&#231;&#227;o entre a varia&#231;&#227;o circadiana da PA e a preval&#234;ncia e gravidade da RH est&#225; ainda pouco esclarecida&#46; De acordo com alguns estudos&#44; a RH &#233; mais frequente e apresenta maior gravidade nos dts <span class="elsevierStyleItalic">non&#8208;dipper</span><a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">No presente estudo&#44; pretendemos avaliar em dts hipertensos a rela&#231;&#227;o entre os valores noturnos de pressurometria em ambulat&#243;rio de 24<span class="elsevierStyleHsp" style=""></span>h e preval&#234;ncia e a gravidade da RH&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Popula&#231;&#227;o e amostra</span><p id="par0035" class="elsevierStylePara elsevierViewall">A popula&#231;&#227;o foi constitu&#237;da por dts hipertensos que realizaram um MAPA no per&#237;odo de janeiro a dezembro de 2013&#46; Os dts foram contactados telefonicamente para a realiza&#231;&#227;o de uma fundoscopia no hospital&#44; com o intuito de avaliar les&#227;o de &#243;rg&#227;o&#8208;alvo&#46; Do total de 355 dts&#44; apenas 46 dts aceitaram realizar o exame&#44; constituindo estes a amostra do estudo&#59; os restantes recusaram ou apresentavam contactos telef&#243;nicos inv&#225;lidos&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Vari&#225;veis</span><p id="par0040" class="elsevierStylePara elsevierViewall">A amostra foi caracterizada de acordo com as suas caracter&#237;sticas basais &#40;idade e sexo&#41;&#59; cl&#237;nicas &#40;antecedentes pessoais&#47;comorbilidades e fatores de risco cardiovasculares&#59; dura&#231;&#227;o &#91;em anos&#93; de HTA&#59; HTA controlada&#41;&#59; laboratoriais &#40;n&#237;veis s&#233;ricos de creatinina&#41;&#59; altera&#231;&#245;es ecocardiogr&#225;ficas &#40;presen&#231;a de hipertrofia conc&#234;ntrica do ventr&#237;culo esquerdo&#41; e de acordo com a terap&#234;utica &#40;grupo de f&#225;rmaco anti&#8208;hipertensor&#41;&#46; Estas vari&#225;veis foram avaliadas a partir de um question&#225;rio entregue ao doente &#40;<a class="elsevierStyleCrossRef" href="#sec0115">Anexo I</a>&#41; e a partir da consulta do processo cl&#237;nico inform&#225;tico&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">No &#226;mbito da caracteriza&#231;&#227;o do perfil tensional foram determinados os valores de PA sist&#243;lica &#40;PAS&#41; e diast&#243;lica &#40;PAD&#41; m&#233;dias noturnas e diurnas&#44; e os dts classificados&#44; por sua vez&#44; de acordo com o perfil tensional noturno em <span class="elsevierStyleItalic">dipper</span> &#40;redu&#231;&#227;o da PA m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>10&#37; e<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>20&#37;&#41;&#44; <span class="elsevierStyleItalic">non&#8208;dipper</span> &#40;redu&#231;&#227;o da PA m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10&#37;&#41;&#44; <span class="elsevierStyleItalic">inverted&#8208;dipper &#40;</span>redu&#231;&#227;o da PA m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#37;&#41; e <span class="elsevierStyleItalic">extreme dipper</span> &#40;redu&#231;&#227;o da PA m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>20&#37;&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Diagn&#243;stico de retinopatia hipertensiva</span><p id="par0050" class="elsevierStylePara elsevierViewall">O diagn&#243;stico de RH foi estabelecido por fundoscopia e a gravidade foi definida utilizando a classifica&#231;&#227;o de Scheie&#44; que caracteriza a presen&#231;a de les&#245;es hipertensivas &#40;est&#225;dios 0&#8208;4&#41; e ateroscler&#243;ticas &#40;graus 0&#8208;4&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lise estat&#237;stica</span><p id="par0055" class="elsevierStylePara elsevierViewall">Para realizar a an&#225;lise estat&#237;stica utilizou&#8208;se o programa <span class="elsevierStyleItalic">IBM SPSS Statistics&#44; vers&#227;o 20</span> para <span class="elsevierStyleItalic">Windows 8&#46;</span> As vari&#225;veis cont&#237;nuas foram expressas em valor m&#233;dio<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>desvio padr&#227;o e comparadas com o teste <span class="elsevierStyleItalic">T&#8208;Student&#39;s</span>&#46; As vari&#225;veis categ&#243;ricas foram expressas em valor absoluto e&#47;ou percentagem e comparadas com o teste quiquadrado&#46; As associa&#231;&#245;es foram consideradas estatisticamente significativas na presen&#231;a de <span class="elsevierStyleItalic">p&#8208;value</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Resultados</span><p id="par0060" class="elsevierStylePara elsevierViewall">Estudaram&#8208;se 46 dts&#59; 46&#37; do sexo masculino &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41;&#44; com idade m&#233;dia 63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12 anos&#46; A presen&#231;a de RH foi observada em 83&#37; dos dts&#44; dos quais 64&#37; apresentavam&#44; de acordo com a classifica&#231;&#227;o de Scheie&#44; um est&#225;dio<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2 &#40;<a class="elsevierStyleCrossRefs" href="#tbl0010">Tabelas 2 e 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Quarenta e dois dts &#40;91&#37;&#41; estavam sob terap&#234;utica anti&#8208;hipertensora&#44; sendo os grupos farmacol&#243;gicos mais frequentes os betabloqueantes em 50&#37; e os diur&#233;ticos em 44&#37; dos dts&#59; posteriormente&#44; os IECA&#44; ARA e antagonistas dos canais de c&#225;lcio numa percentagem id&#234;ntica&#44; 39&#37; cada&#46; Com a terap&#234;utica institu&#237;da&#44; 30&#37; dos dts apresentava uma PA controlada &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Tabela 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">No &#226;mbito das comorbilidades e fatores de risco&#44; a dislipidemia e a diabetes <span class="elsevierStyleItalic">mellitus</span> foram as mais frequentes&#44; respetivamente em 91 e 35&#37;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">O perfil <span class="elsevierStyleItalic">non&#8208;dipper</span> foi observado em 37&#37; dos dts&#59; por sua vez&#44; o <span class="elsevierStyleItalic">dipper</span> em 48&#37;&#44; <span class="elsevierStyleItalic">extreme dipper</span> em 7&#37; e&#44; por fim&#44; o <span class="elsevierStyleItalic">inverted&#8208;dipper</span> em 9&#37;&#46; Os valores m&#233;dios de PAS e PAD noturnas foram&#44; respetivamente&#44; de 148<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23 e 66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9<span class="elsevierStyleHsp" style=""></span>mmHg &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Tabela 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Os n&#237;veis m&#233;dios de creatinina foram 1&#44;07<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;7<span class="elsevierStyleHsp" style=""></span>mg&#47;dl na amostra e&#44; por sua vez&#44; 1&#44;12<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>07 nos dts com RH&#46; Cinquenta e tr&#234;s por centro dos dts apresentavam crit&#233;rios ecocardiogr&#225;ficos de hipertrofia ventricular esquerda &#40;HVE&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Tabela 5</a>&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discuss&#227;o</span><p id="par0085" class="elsevierStylePara elsevierViewall">A RH apresentou uma elevada preval&#234;ncia na nossa popula&#231;&#227;o &#40;83&#37;&#41;&#44; o que vai em concord&#226;ncia com a bibliografia&#44; sendo que altera&#231;&#245;es na microvasculatura da retina desenvolvem&#8208;se em 50&#8208;80&#37; dos dts hipertensos<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">A idade avan&#231;ada &#40;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9 anos&#41; e maior tempo de evolu&#231;&#227;o da hipertens&#227;o &#40;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12 anos&#41; foram associados a maior risco de retinopatia&#44; com significado estat&#237;stico&#46; Por sua vez&#44; o g&#233;nero bem como os antecedentes pessoais n&#227;o estiveram associados a maior risco de retinopatia&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Na teoria&#44; dts sob terap&#234;utica com HTA controlada apresentam menor risco de les&#245;es de &#243;rg&#227;o&#8208;alvo&#44; ou&#44; pelo menos&#44; uma evolu&#231;&#227;o mais lenta e progressiva&#44; contudo nesta popula&#231;&#227;o n&#227;o se conseguiu estabelecer essa associa&#231;&#227;o&#46; Apenas 38&#37; dos dts com HTA controlada n&#227;o apresentou qualquer les&#227;o microvascular da retina &#40;HTA n&#227;o controlada &#8211; 85&#37; &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>28&#93; RH <span class="elsevierStyleItalic">versus</span> 15&#37; &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#93; sem RH&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>ns&#59; HTA controlada &#8211; 77&#37; &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#93; RH <span class="elsevierStyleItalic">versus</span> 23&#37; &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#93; sem RH&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>ns&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">N&#237;veis m&#233;dios de creatinina elevados estiveram associados &#224; presen&#231;a de RH&#59; por sua vez&#44; com a hipertrofia do ventr&#237;culo esquerdo n&#227;o se conseguiu estabelecer essa associa&#231;&#227;o&#46; De acordo com a bibliografia&#44; as les&#245;es de &#243;rg&#227;o associadas &#224; hipertens&#227;o s&#227;o mais frequentes e precoces ao n&#237;vel do cora&#231;&#227;o &#40;HVE&#59; disfun&#231;&#227;o diast&#243;lica&#41; do que na retina e no rim&#59; eventualmente&#44; n&#227;o se conseguiu estabelecer uma associa&#231;&#227;o entre HVE e retinopatia&#44; pela reduzida dimens&#227;o da amostra<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">N&#227;o existiu qualquer diferen&#231;a estat&#237;stica entre a presen&#231;a de retinopatia e a classe do f&#225;rmaco anti&#8208;hipertensor&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">De acordo com v&#225;rios estudos&#44; os perfis <span class="elsevierStyleItalic">non&#8208;dipper</span> e <span class="elsevierStyleItalic">extreme dipper</span> est&#227;o associados a mais les&#245;es de &#243;rg&#227;o&#8208;alvo e a um importante impacto cardiovascular&#46; No &#226;mbito das les&#245;es da retina&#44; os estudos s&#227;o muito escassos&#44; contudo tem&#8208;se observado que essas les&#245;es s&#227;o mais frequentes e com maior gravidade nos dts <span class="elsevierStyleItalic">non&#8208;dipper</span><a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#8211;6</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Nenhum perfil tensional noturno esteve associado a maior risco de retinopatia&#44; apesar da elevada preval&#234;ncia dos perfis <span class="elsevierStyleItalic">dipper</span> e <span class="elsevierStyleItalic">non&#8208;dipper</span> nos dts com RH&#44; respetivamente 47 e 39&#37;&#44; contudo sem significado estat&#237;stico&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Por sua vez&#44; valores elevados de PAS noturna e diurna &#40;PAS noturna &#8211; RH 151<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23 <span class="elsevierStyleItalic">versus</span> sem RH 130<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13<span class="elsevierStyleHsp" style=""></span>mmHg&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#59; PAS diurna &#8211; RH 139<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14 <span class="elsevierStyleItalic">versus</span> 129<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8<span class="elsevierStyleHsp" style=""></span>mmHg&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41; foram associados &#224; presen&#231;a de retinopatia&#46; A gravidade da retinopatia foi observada em valores de PAS noturna elevados &#40;PAS noturna &#8211; RH est&#225;dio<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2153<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25 <span class="elsevierStyleItalic">versus</span> RH sem gravidade 140<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16<span class="elsevierStyleHsp" style=""></span>mmHg&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#46; Nos dts hipertensos&#44; a PAS demonstrou maior influ&#234;ncia do que a PAD no impacto negativo ao n&#237;vel da microvasculatura da retina&#46; Estudos observacionais t&#234;m demonstrado que a PAS &#233; um importante e independente preditor de risco para doen&#231;a cardiovascular e renal<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a>&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Limita&#231;&#245;es</span><p id="par0125" class="elsevierStylePara elsevierViewall">A reduzida dimens&#227;o da amostra constituiu uma das principais limita&#231;&#245;es do estudo&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclus&#227;o</span><p id="par0130" class="elsevierStylePara elsevierViewall">A RH apresentou uma elevada preval&#234;ncia na amostra em estudo&#44; sendo associada &#224; idade avan&#231;ada e a maior tempo de evolu&#231;&#227;o da hipertens&#227;o&#46; N&#227;o se verificou uma rela&#231;&#227;o entre um perfil tensional noturno e a presen&#231;a e&#47;ou gravidade da RH&#46; N&#237;veis mais elevados de PAS noturna estiveram associados a uma maior preval&#234;ncia e gravidade de retinopatia&#46; Apesar da reduzida amostra&#44; a PAS foi associada a maior risco de les&#227;o microvascular da retina&#44; quando comparada com a PAD&#46; Tendo em conta a elevada preval&#234;ncia da retinopatia na popula&#231;&#227;o de dts hipertensos e pelo impacto negativo do ponto de vistas cardiovascular&#44; que tem sido evidenciado em v&#225;rios estudos&#44; a avalia&#231;&#227;o da retina deve fazer parte do exame f&#237;sico de um doente hipertenso e a terap&#234;utica dirigida preferencialmente &#224; corre&#231;&#227;o da PAS&#46; De qualquer modo&#44; s&#227;o necess&#225;rios mais estudos com amostras bem dimensionadas para evidenciar uma rela&#231;&#227;o entre um perfil tensional e a retinopatia&#44; bem como para um correto ajuste terap&#234;utico&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflito de interesses</span><p id="par0135" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesses&#46;</p></span></span>"
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          "titulo" => "Palavras&#8208;chave"
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          "titulo" => "Abstract"
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              "identificador" => "abst0030"
              "titulo" => "Introduction"
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          "titulo" => "Introdu&#231;&#227;o"
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              "identificador" => "sec0015"
              "titulo" => "Popula&#231;&#227;o e amostra"
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            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Vari&#225;veis"
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            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Diagn&#243;stico de retinopatia hipertensiva"
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            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "An&#225;lise estat&#237;stica"
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          "titulo" => "Limita&#231;&#245;es"
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          "titulo" => "Conclus&#227;o"
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        10 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Conflito de interesses"
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        11 => array:1 [
          "titulo" => "Bibliografia"
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    "fechaRecibido" => "2017-02-12"
    "fechaAceptado" => "2017-06-29"
    "PalabrasClave" => array:2 [
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras&#8208;chave"
          "identificador" => "xpalclavsec963281"
          "palabras" => array:3 [
            0 => "Perfil dipper"
            1 => "MAPA"
            2 => "Retinopatia hipertensiva"
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec963282"
          "palabras" => array:3 [
            0 => "Dipper profile"
            1 => "Ambulatory blood pressure monitoring"
            2 => "Hypertensive retinopathy"
          ]
        ]
      ]
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    "resumen" => array:2 [
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Os perfis tensionais noturnos <span class="elsevierStyleItalic">non&#8208;dipper</span> e <span class="elsevierStyleItalic">extreme</span>&#8208;<span class="elsevierStyleItalic">dipper</span> t&#234;m sido associados a les&#245;es de &#243;rg&#227;o&#8208;alvo&#46; A rela&#231;&#227;o entre a press&#227;o arterial &#40;PA&#41; e retinopatia hipertensiva &#40;RH&#41; est&#225; pouco esclarecida&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Avaliar em doentes &#40;dts&#41; hipertensos a rela&#231;&#227;o entre os valores noturnos de pressurometria em ambulat&#243;rio de 24<span class="elsevierStyleHsp" style=""></span>h &#40;MAPA&#41; e preval&#234;ncia e a gravidade da RH&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Foram avaliados prospectivamente dts hipertensos submetidos &#224; realiza&#231;&#227;o de MAPA de 24<span class="elsevierStyleHsp" style=""></span>h&#46; Foram determinadas caracter&#237;sticas basais&#44; PA sist&#243;lica &#40;PAS&#41; e diast&#243;lica &#40;PAD&#41; m&#233;dias noturnas&#44; e os dts classificados pelo perfil tensional noturno em <span class="elsevierStyleItalic">dipper&#59; non&#8208;dipper&#59; inverted&#8208;dipper</span> e <span class="elsevierStyleItalic">extreme&#8208;dipper&#46;</span> O diagn&#243;stico de RH foi estabelecido por fundoscopia e a gravidade definida pela classifica&#231;&#227;o de Scheie&#46; Foi estabelecida a rela&#231;&#227;o entre valores de PAS e PAD noturnos e o perfil tensional noturno com a preval&#234;ncia e gravidade da RH&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Foram avaliados 46 dts &#40;46&#37; sexo masculino &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#93;&#59; idade m&#233;dia 63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12 anos&#41;&#46; Noventa e um por cento dos dts estavam sob terap&#234;utica anti&#8208;hipertensora &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#41;&#59; destes&#44; 30&#37; apresentavam PA controlada &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41;&#46; A presen&#231;a de RH foi observada em 83&#37; dos dts &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41;&#46; Os dts com RH apresentaram n&#237;veis de PAS noturna mais elevados &#40;151<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23 <span class="elsevierStyleItalic">versus</span> 130<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#41;&#46; A PAS noturna esteve ainda associada a uma maior gravidade de RH &#40;153<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25 <span class="elsevierStyleItalic">versus</span> 140<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#46; N&#227;o existiu rela&#231;&#227;o entre a PAD noturna ou o perfil tensional noturno e presen&#231;a de RH&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclus&#227;o</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">N&#237;veis mais elevados de PAS noturna estiveram associados a RH&#46; N&#227;o se verificou rela&#231;&#227;o entre o perfil tensional noturno e a presen&#231;a de RH&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introdu&#231;&#227;o"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objetivo"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "M&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclus&#227;o"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Non&#8208;dipper and extreme dipper blood pressure &#40;BP&#41; profiles are associated with a worse cardiovascular prognosis&#46; The relationship between nocturnal BP profile and hypertensive retinopathy &#40;HR&#41; is not fully established&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Aim</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">To assess the association between the prevalence and severity of HR and nocturnal BP&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">We prospectively studied hypertensive patients who underwent 24&#8208;hour ambulatory BP monitoring&#46; The population was divided into two groups according to the presence or absence of lesions and compared according to baseline characteristics&#44; nocturnal BP profile &#40;dippers&#44; non&#8208;dippers&#44; inverted dippers&#47;risers and extreme dippers&#41; and mean nocturnal systolic &#40;SBP&#41; and diastolic &#40;DBP&#41; BP values&#46; The presence and severity of HR were assessed using the Scheie classification&#46; The relationship between nocturnal SBP and DBP values &#40;and nocturnal BP profile&#41; and the prevalence and severity of HR was determined&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Forty&#8208;six patients &#40;46&#37; male&#44; aged 63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12 years&#41; were analyzed&#44; of whom 91&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#41; were under antihypertensive treatment&#46; Seventy percent &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#41; had uncontrolled BP&#46; HR was diagnosed in 83&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41;&#46; Patients with HR had higher mean systolic nocturnal BP &#40;151<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23 vs&#46; 130<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13 mmHg&#41;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#46; Patients with greater HR severity &#40;Scheie stage &#8805;<span class="elsevierStyleHsp" style=""></span>2&#41; had higher nocturnal BP &#40;153<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25 vs&#46; 140<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16 mmHg&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#46; There was no statistically significant association between DBP and nocturnal BP patterns and HR&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">The prevalence and severity of HR were associated with higher nocturnal SBP&#46; No relationship was observed between nocturnal BP profile and the presence of HR&#46;</p></span>"
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            "titulo" => "Introduction"
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            "titulo" => "Aim"
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            "titulo" => "Methods"
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            "titulo" => "Results"
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            "etiqueta" => "Appendix B"
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estreitamento arteriolar difuso&#46; Sem constri&#231;&#245;es focais&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estreitamento arteriolar mais pronunciado com constri&#231;&#245;es focais&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Estreitamento difuso e focal&#46; Observa&#8208;se hemorragia da retina&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Edema e exsudados da retina&#59; edema do disco &#243;tico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Retinopatia hipertensiva<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sexo masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;45&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;45&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Antecedentes pessoais</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes <span class="elsevierStyleItalic">mellitus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;34&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;37&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dislipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;91&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34 &#40;89&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DAP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;35&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;40&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Antecedentes EAM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Antecedentes de AVC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;17&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;18&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;13&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Evolu&#231;&#227;o da HTA</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dura&#231;&#227;o &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;027&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">A negrito&#44; os perfis tensionais que apresentaram diferen&#231;as estat&#237;stica entre a exist&#234;ncia e gravidade da RH&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Popula&#231;&#227;o<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Retinopatia hipertensiva<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sem RH<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p&#8208;value</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">RH sem gravidade<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">RH com gravidade &#40;est&#225;dio<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2&#41;<br>&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p&#8208;value</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Dipper</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;47&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;46&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Extreme dipper</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Inverted&#8208;dipper</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;15&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Non&#8208;dipper</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;37&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;39&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;31&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;44&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PAS noturna &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">148</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">23</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">151</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">23</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">130</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">13</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">0&#44;008</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">140</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">16</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">153</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">25</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">0&#44;04</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PAD noturna &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PAS diurna &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">138</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">13&#44;4</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">139</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">14</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">129</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">8</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">0&#44;021</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">135<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">140<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&nbsp;\t\t\t\t\t\t\n
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