Letizia C, Ferrari P, Cotesta D, Caliumi C, Cianci R, Cerci S, Petramala L, Celi M, Minisola S, D'Erasmo E, Mazzuoli G F
Department of Clinical Science, University of Rome La Sapienza, Rome, Italy.
J Hum Hypertens. 2005 Nov;19(11):901-6. doi: 10.1038/sj.jhh.1001907.
The purpose of our study was to evaluate the behaviour of blood pressure (BP) by ambulatory monitoring of blood pressure (AMBP) in 53 patients with primary hyperparathyroidism (PHPT) compared to 100 essential hypertensive (EH) and 31 healthy subjects (HS). The correlations between calcium-phosphorus metabolism and haemodynamic parameters in all groups are included in the study. AMBP was performed using the oscillometric technique (Space-Labs, 90207, Redmond, WA, USA) and the following AMBP parameters were evaluated: average day time systolic (S) and diastolic (D) blood pressure (BP) and heart rate (HR) (when awake), average night time SBP, DBP and HR (when asleep) and average 24-h-SBP, DBP and HR. The definition of 'dipper' or 'non-dipper' subjects was established if night time SBP and DBP fall was >10% and <10%, respectively. In total, 25 PHPT patients (47.2%) were hypertensive (HT-PHPT) and 28 PHPT (52.8%) were normotensive (NT-PHPT). Mean 24-h-SBP and DBP obtained by AMBP was higher in HT-PHPT (P < 0.05) and EH (P < 0.05) than in NT-PHPT and HS. The multiple linear regression has shown that in PHPT-HT patients ionized calcium is an independent factor for the rise of 24-h-DBP values (r: 0.497; P < 0.05) and daytime DBP values (r: 0.497; P < 0.05). In 56% of HT-PHPT patients there is an absence of physiological BP nocturnal fall ('non-dipper'), which is statistically significant (P < 0.05) compared with 'non-dipper' EH patients (30%). In conclusion, in our study the prevalence of hypertension in PHPT was 47%. AMBP revealed that the 'non-dipping 'pattern was much higher in HT-PHPT patients in respect to EH patients.
我们研究的目的是通过动态血压监测（AMBP）评估53例原发性甲状旁腺功能亢进症（PHPT）患者的血压行为，并与100例原发性高血压（EH）患者和31例健康受试者（HS）进行比较。本研究纳入了所有组中钙磷代谢与血流动力学参数之间的相关性。使用示波技术（Space-Labs，90207，美国华盛顿州雷德蒙德）进行AMBP，并评估以下AMBP参数：白天平均收缩压（S）和舒张压（D）、血压（BP）和心率（HR）（清醒时）、夜间平均收缩压、舒张压和心率（睡眠时）以及平均24小时收缩压、舒张压和心率。如果夜间收缩压和舒张压下降分别>10%和<10%，则确定为“杓型”或“非杓型”受试者。总共有25例PHPT患者（47.2%）患有高血压（HT-PHPT），28例PHPT患者（52.8%）血压正常（NT-PHPT）。通过AMBP获得的HT-PHPT组（P<0.05）和EH组（P<0.05）的平均24小时收缩压和舒张压高于NT-PHPT组和HS组。多元线性回归表明，在PHPT-HT患者中，离子钙是24小时舒张压值升高（r：0.497；P<0.05）和白天舒张压值升高（r：0.497；P<0.05）的独立因素。在56%的HT-PHPT患者中，夜间血压没有生理性下降（“非杓型”），与“非杓型”EH患者（30%）相比具有统计学意义（P<0.05）。总之，在我们的研究中，PHPT患者中高血压的患病率为47%。AMBP显示，HT-PHPT患者的“非杓型”模式相对于EH患者要高得多。
