Analysis of Short-term Blood Pressure Variability in Pheochromocytoma/Paraganglioma Patients

Valeria Bisogni; Luigi Petramala; Gaia Oliviero; Maria Bonvicini; Martina Mezzadri; Federica Olmati; Antonio Concistrè; Vincenza Saracino; Monia Celi; Gianfranco Tonnarini; Gino Iannucci; Giorgio De Toma; Antonio Ciardi; Giuseppe La Torre; Claudio Letizia

doi:10.3390/cancers11050658

Analysis of Short-term Blood Pressure Variability in Pheochromocytoma/Paraganglioma Patients

Cancers (Basel). 2019 May 12;11(5):658. doi: 10.3390/cancers11050658.

Authors

Affiliations

¹ Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. valeria.bisogni@hotmail.it.
² Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. luigi.petramala@uniroma1.it.
³ Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. gaiaoliviero2@gmail.com.
⁴ Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. bonvimery@gmail.com.
⁵ Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. mezzadri.1615511@studenti.uniroma1.it.
⁶ Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. federica.kolmati@gmail.com.
⁷ Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. antonio.concistre@gmail.com.
⁸ Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. vincenza.saracino@gmail.com.
⁹ Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. celi.monia@gmail.com.
¹⁰ Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. gianfranco.tonnarini@uniroma1.it.
¹¹ Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. gino.iannucci@uniroma1.it.
¹² "Pietro Valdoni" Surgery Department, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. giorgio.detoma@uniroma1.it.
¹³ Department of Radiological, Oncological and Anatomy-Pathological Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. antonio.ciardi@uniroma1.it.
¹⁴ Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. giuseppe.latorre@uniroma1.it.
¹⁵ Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy. claudio.letizia@uniroma1.it.

Abstract

Data on short-term blood pressure variability (BPV), which is a well-established cardiovascular prognostic tool, in pheochromocytoma and paraganglioma (PPGL) patients is still lack and conflicting. We retrospectively evaluated 23 PPGL patients referred to our unit from 2010 to 2019 to analyze 24 h ambulatory blood pressure monitoring (24-h ABPM)-derived markers of short-term BPV, before and after surgical treatment. PPGL diagnosis was assessed according to guidelines and confirmed by histologic examination. The 24-h ABPM-derived markers of short-term BPV included: circadian pressure rhythm; standard deviation (SD) and weighted SD (wSD) of 24-h, daytime, and night-time systolic and diastolic blood pressure (BP); average real variability (ARV) of 24-h, daytime, and night-time systolic and diastolic BP. 7 males and 16 females of 53 ± 18 years old were evaluated. After surgical resection of PPGL we found a significant decrease in 24-h systolic BP ARV (8.8 ± 1.6 vs. 7.6 ± 1.3 mmHg, p < 0.001), in 24-h diastolic BP ARV (7.5 ± 1.6 vs. 6.9 ± 1.4 mmHg, p = 0.031), and in wSD of 24-h diastolic BP (9.7 ± 2.0 vs 8.8 ± 2.1 mmHg, p = 0.050) comparing to baseline measurements. Moreover, baseline 24-h urinary metanephrines significantly correlated with wSD of both 24-h systolic and diastolic BP. Our study highlights as PPGL patients, after proper treatment, show a significant decrease in some short-term BPV markers, which might represent a further cardiovascular risk factor.

Keywords: average real variability; blood pressure variability; hypertension; paraganglioma; pheochromocytoma; weighted standard deviation.