Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan,
Clin Exp Nephrol. 2015 Feb;19(1):114-24. doi: 10.1007/s10157-014-0965-2. Epub 2014 Mar 30.
High prevalence of masked hypertension as well as persistent hypertension was observed in the Chronic Kidney Disease Japan Cohort (CKD-JAC) study. We proposed a novel indicator of blood pressure (BP) load, hyperbaric area index (HBI), calculated from ambulatory blood pressure monitoring (ABPM) data. The characteristic of this index and its relationship with kidney function were also evaluated.
The CKD-JAC study, enrolled 2,977 patients, is a prospective observational study started in September 2007. ABPM was conducted in a sub-group from September 2007 to April 2010 and baseline ABPM data of 1,075 subjects (63.4 % male, 60.7 years old) were analyzed.
Mean systolic HBI of male and female patients were 242.3 and 176.5 mmHg×h, respectively. HBI sensitively reflected sex (54.7 mmHg×h higher in males than in females), seasonal effects (51.6 mmHg×h higher in winter than in summer), and advancing CKD stage [(16.5 mmHg×h higher) per -10 mL/min/1.73 m(2) in eGFR]. The HBI was a significant factor to associate with reduced kidney function, after adjusting with nocturnal BP change (NBPC), sex, and other variables (p value <0.001).
Our findings suggested that HBI might be a novel sensitive indicator for the reduction of kidney function, independent of patterns of NBPC.
在慢性肾脏病日本队列研究（CKD-JAC 研究）中观察到了掩蔽性高血压和持续性高血压的高发率。我们提出了一种新的血压（BP）负荷指标，即从动态血压监测（ABPM）数据中计算得出的高压区指数（HBI）。还评估了该指数的特征及其与肾功能的关系。
CKD-JAC 研究是一项前瞻性观察性研究，于 2007 年 9 月开始招募了 2977 名患者。ABPM 于 2007 年 9 月至 2010 年 4 月在一个子组中进行，分析了 1075 名受试者（63.4%为男性，60.7 岁）的基线 ABPM 数据。
男性和女性患者的平均收缩压 HBI 分别为 242.3 和 176.5mmHg×h。HBI 敏感地反映了性别（男性比女性高 54.7mmHg×h）、季节性影响（冬季比夏季高 51.6mmHg×h）和进展性 CKD 分期[（eGFR 每降低 10mL/min/1.73m2，增加 16.5mmHg×h]。在调整夜间血压变化（NBPC）、性别和其他变量后，HBI 是与肾功能下降相关的重要因素（p 值<0.001）。
我们的研究结果表明，HBI 可能是肾功能下降的一种新的敏感指标，与 NBPC 模式无关。
