Erciyes University, School of Medicine, Department of Cardiology, Kayseri, Turkey.
Atherosclerosis. 2010 Mar;209(1):278-82. doi: 10.1016/j.atherosclerosis.2009.09.010. Epub 2009 Sep 12.
Non-dipper hypertensives had about three times the risk of atherosclerotic events than hypertensives whose blood pressure was >10% lower at night compared to daytime (dippers). Platelet activation and inflammatory response may derive from most atherosclerotic events. Mean platelet volume (MPV) is a determinant of platelet activation and high sensitive C-reactive protein (hs-CRP) is the best candidate assay to identify and monitor the inflammatory response. We aimed to determine whether MPV and hs-CRP levels are elevated in non-dipper patients compared to dippers and healthy controls. In addition, we tried to find out if MPV and CRP are related to each other or not in non-dipper hypertensives.
The total 126 patients study group included 86 patients with hypertension and 40 healthy subjects (16 male, mean age; 51+/-4) as control. Ambulatory blood pressure monitoring was performed for all patients. Hypertensive patients were divided into two groups; 46 dipper patients (18 male, mean age; 50+/-9) and 40 non-dipper patients (17 male, mean age; 53+/-11). Clinical baseline characteristics were similar between groups. We measured mean platelet volume in a blood sample collected in EDTA tubes and high-sensitive CRP was measured by using BN2 model nephlometer.
Non-dipper patients demonstrated higher levels of MPV compared to dippers and normotensives (9.72+/-0.52 fl vs 9.38+/-0.33 fl and 8.92+/-0.42 fl, p<0.05, respectively). High-sensitive CRP levels were also significantly higher in non-dippers compared to dippers and normotensives (4.9+/-1.7mg/l vs 3.8+/-1.5mg/l and 2.7+/-0.8mg/l, p<0.05, respectively). There was significant positive correlation between MPV and CRP levels (p=0.002, r=0.482) in non-dipper hypertensives.
Our results suggest that patients with non-dipping tend to have increased platelet activation and inflammatory response. Increased platelet activation and inflammatory response could contribute to increase the atherosclerotic risk in non-dipper patients compared to dippers.
与夜间血压较日间下降>10%的杓型高血压患者相比，非杓型高血压患者发生动脉粥样硬化事件的风险约增加 3 倍。血小板激活和炎症反应可能源自大多数动脉粥样硬化事件。平均血小板体积（MPV）是血小板激活的决定因素，高敏 C 反应蛋白（hs-CRP）是识别和监测炎症反应的最佳候选指标。我们旨在确定与杓型高血压患者相比，非杓型患者的 MPV 和 hs-CRP 水平是否升高。此外，我们还试图确定非杓型高血压患者的 MPV 和 CRP 是否相关。
该研究共纳入 126 例患者，其中 86 例高血压患者和 40 例健康对照者（16 名男性，平均年龄 51+/-4 岁）。对所有患者进行动态血压监测。将高血压患者分为两组：46 例杓型高血压患者（18 名男性，平均年龄 50+/-9 岁）和 40 例非杓型高血压患者（17 名男性，平均年龄 53+/-11 岁）。两组患者的临床基线特征相似。我们使用 EDTA 管采集的血样测量平均血小板体积，使用 BN2 型号肾功仪测量高敏 CRP。
与杓型高血压患者和血压正常者相比，非杓型高血压患者的 MPV 水平更高（9.72+/-0.52 fl 比 9.38+/-0.33 fl 和 8.92+/-0.42 fl，p<0.05）。非杓型高血压患者的 hs-CRP 水平也明显高于杓型高血压患者和血压正常者（4.9+/-1.7mg/l 比 3.8+/-1.5mg/l 和 2.7+/-0.8mg/l，p<0.05）。非杓型高血压患者的 MPV 和 CRP 水平之间存在显著正相关（p=0.002，r=0.482）。
我们的研究结果表明，非杓型高血压患者的血小板激活和炎症反应增强。与杓型高血压患者相比，血小板激活和炎症反应的增加可能导致非杓型高血压患者的动脉粥样硬化风险增加。
