Blood pressure trend in hospitalized adult dengue patients
Background: Monitoring of blood pressure is an important part of management of dengue illness. Large scale studies of temporal trend of blood pressure in adult dengue are lacking. In this study, we examined the differences in time trend of systolic (SBP) and diastolic blood pressure (DBP) in patient...
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sg-ntu-dr.10356-1470862023-03-05T16:49:22Z Blood pressure trend in hospitalized adult dengue patients Yeung, Wesley Lye, David Chien Boon Thein, Tun-Linn Chen, Yirong Leo, Yee-Sin Lee Kong Chian School of Medicine (LKCMedicine) Science::Medicine Dengue Fever Hypertension Background: Monitoring of blood pressure is an important part of management of dengue illness. Large scale studies of temporal trend of blood pressure in adult dengue are lacking. In this study, we examined the differences in time trend of systolic (SBP) and diastolic blood pressure (DBP) in patients with and without severe dengue (SD), dengue hemorrhagic fever (DHF) and pre-existing hypertension, and elderly versus non-elderly patients. Methods: We studied a retrospective cohort from 2005 to 2008 of 6,070 hospitalized adult dengue patients confirmed by polymerase chain reaction or clinical criteria plus positive dengue serology. Dengue severity was defined according to World Health Organization 1997 and 2009 guidelines. We used Bayesian hierarchical Markov models to compare the daily mean SBP and DBP between different subgroups. Analysis was conducted by day of defervescence (denoted as day 0), and day of illness onset (denoted as day 1) respectively. Results: SBP decreased to a nadir during the critical phase before defervescence and was significantly lower for patients with SD or DHF, compared with patients without SD or DHF. DBP increased marginally more for patients with SD or DHF in the critical phase before defervescence. By day of defervescence, comparison of patients with and without SD showed significant difference in SBP from day -6 to day +6, except days +1, +3 and +5, and similarly in DBP except days 0, and +4 to +6. Comparison of patients with and without DHF showed significant difference in SBP from day -6 to day -1, but for DBP, significant difference was noted from day -6 to day +6, except day -2 to day 0. By day of illness, SBP differed significantly between patients with and without SD from illness days 1 to 10, and DBP from illness days 7 to 12. Between patients with and without DHF, SBP differed significantly on illness days 1, 2, 4 to 7, while DBP from days 7 to 12. On analysis by days of defervescence or by days of illness, elderly patients and those with hypertension showed consistently higher SBP and DBP throughout their hospitalization, as compared with their younger and non-hypertensive counterparts. Conclusions: In SD or DHF, SBP decreased to a nadir around the day of defervescence, and recovered to a level exceeding that in febrile phase by days 2 or 3 post-defervescence. Elderly patients and patients with pre-existing hypertension maintained higher SBP and DBP throughout the duration of dengue infection. National Medical Research Council (NMRC) National Research Foundation (NRF) Published version This work was supported by the National Research Foundation through the National Medical Research Council, Singapore [Grant Number NMRC/TCR/005/2008]. The funders had no role in study design, data collection, analysis, decision to publish or preparation of the manuscript. 2021-03-26T04:29:57Z 2021-03-26T04:29:57Z 2020 Journal Article Yeung, W., Lye, D. C. B., Thein, T., Chen, Y. & Leo, Y. (2020). Blood pressure trend in hospitalized adult dengue patients. PloS One, 15(7). https://dx.doi.org/10.1371/journal.pone.0235166 1932-6203 https://hdl.handle.net/10356/147086 10.1371/journal.pone.0235166 32609737 2-s2.0-85087471541 7 15 en NMRC/TCR/005/2008 PloS One © 2020 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. application/pdf |
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Science::Medicine Dengue Fever Hypertension Yeung, Wesley Lye, David Chien Boon Thein, Tun-Linn Chen, Yirong Leo, Yee-Sin Blood pressure trend in hospitalized adult dengue patients |
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Background: Monitoring of blood pressure is an important part of management of dengue illness. Large scale studies of temporal trend of blood pressure in adult dengue are lacking. In this study, we examined the differences in time trend of systolic (SBP) and diastolic blood pressure (DBP) in patients with and without severe dengue (SD), dengue hemorrhagic fever (DHF) and pre-existing hypertension, and elderly versus non-elderly patients. Methods: We studied a retrospective cohort from 2005 to 2008 of 6,070 hospitalized adult dengue patients confirmed by polymerase chain reaction or clinical criteria plus positive dengue serology. Dengue severity was defined according to World Health Organization 1997 and 2009 guidelines. We used Bayesian hierarchical Markov models to compare the daily mean SBP and DBP between different subgroups. Analysis was conducted by day of defervescence (denoted as day 0), and day of illness onset (denoted as day 1) respectively. Results: SBP decreased to a nadir during the critical phase before defervescence and was significantly lower for patients with SD or DHF, compared with patients without SD or DHF. DBP increased marginally more for patients with SD or DHF in the critical phase before defervescence. By day of defervescence, comparison of patients with and without SD showed significant difference in SBP from day -6 to day +6, except days +1, +3 and +5, and similarly in DBP except days 0, and +4 to +6. Comparison of patients with and without DHF showed significant difference in SBP from day -6 to day -1, but for DBP, significant difference was noted from day -6 to day +6, except day -2 to day 0. By day of illness, SBP differed significantly between patients with and without SD from illness days 1 to 10, and DBP from illness days 7 to 12. Between patients with and without DHF, SBP differed significantly on illness days 1, 2, 4 to 7, while DBP from days 7 to 12. On analysis by days of defervescence or by days of illness, elderly patients and those with hypertension showed consistently higher SBP and DBP throughout their hospitalization, as compared with their younger and non-hypertensive counterparts. Conclusions: In SD or DHF, SBP decreased to a nadir around the day of defervescence, and recovered to a level exceeding that in febrile phase by days 2 or 3 post-defervescence. Elderly patients and patients with pre-existing hypertension maintained higher SBP and DBP throughout the duration of dengue infection. |
author2 |
Lee Kong Chian School of Medicine (LKCMedicine) |
author_facet |
Lee Kong Chian School of Medicine (LKCMedicine) Yeung, Wesley Lye, David Chien Boon Thein, Tun-Linn Chen, Yirong Leo, Yee-Sin |
format |
Article |
author |
Yeung, Wesley Lye, David Chien Boon Thein, Tun-Linn Chen, Yirong Leo, Yee-Sin |
author_sort |
Yeung, Wesley |
title |
Blood pressure trend in hospitalized adult dengue patients |
title_short |
Blood pressure trend in hospitalized adult dengue patients |
title_full |
Blood pressure trend in hospitalized adult dengue patients |
title_fullStr |
Blood pressure trend in hospitalized adult dengue patients |
title_full_unstemmed |
Blood pressure trend in hospitalized adult dengue patients |
title_sort |
blood pressure trend in hospitalized adult dengue patients |
publishDate |
2021 |
url |
https://hdl.handle.net/10356/147086 |
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1759853396861386752 |