Elsurer R, Afsar B
Department of Nephrology, Selcuk University Faculty of Medicine, Konya, Turkey.
Department of Nephrology, Konya Numune Hospital, Konya, Turkey.
J Hum Hypertens. 2015 May;29(5):331-6. doi: 10.1038/jhh.2014.74. Epub 2014 Aug 28.
The phenomenon that blood pressure rises sharply in the morning is called 'Morning Blood Pressure Surge' (MBPS). Serum gamma-glutamyltransferase (GGT) is a proinflammatory marker involved in the pathogenesis of cardiovascular diseases. Although both are novel cardiovascular risk factors associated with inflammation and atherosclerosis, the specific relationship between MBPS and serum GGT is unknown. This study investigates the relationship between MBPS and serum GGT activity in essential hypertensive patients. Totally, 320 hypertensive patients were recruited. Mean MBPS was 17.0 ± 12.9 mm Hg. MBPS was positively correlated with age (r = +0.222, P < 0.0001), body mass index (r = +0.132, P = 0.018), GGT (r = +0.271, P < 0.0001), daytime augmentation index adjusted for heart rate (AIx@75) (r = +0.140, P=0.014), 24-h pulse wave velocity (PWV) (r = +0.143, P = 0.014) and daytime PWV (r = +0.158, P = 0.007). From the 25th to 75th quartile of serum GGT, MBPS increased significantly (Ptrend < 0.0001). In multivariate linear regression analysis, MBPS was independently associated with age (P = 0.002), dipping status (P < 0.0001) and logGGT (P < 0.0001). In conclusion, MBPS is independently associated serum GGT activity in essential hypertensive patients. This is the first study in the literature to demonstrate an independent and a dose-response relationship between the two novel cardiovascular risk factors, MBPS and serum GGT, in this patient population.
早晨血压急剧上升的现象被称为“早晨血压激增”(MBPS)。血清γ-谷氨酰转移酶(GGT)是一种参与心血管疾病发病机制的促炎标志物。虽然两者都是与炎症和动脉粥样硬化相关的新型心血管危险因素,但MBPS与血清GGT之间的具体关系尚不清楚。本研究调查了原发性高血压患者中MBPS与血清GGT活性之间的关系。总共招募了320名高血压患者。平均MBPS为17.0±12.9 mmHg。MBPS与年龄呈正相关(r = +0.222,P < 0.0001)、体重指数呈正相关(r = +0.132,P = 0.018)、GGT呈正相关(r = +0.271,P < 0.0001)、经心率校正的日间增强指数(AIx@75)呈正相关(r = +0.140,P = 0.014)、24小时脉搏波速度(PWV)呈正相关(r = +0.143,P = 0.014)以及日间PWV呈正相关(r = +0.158,P = 0.007)。从血清GGT的第25至75四分位数来看,MBPS显著升高(Ptrend < 0.0001)。在多变量线性回归分析中,MBPS与年龄独立相关(P = 0.002)、血压波动状态独立相关(P < 0.0001)以及logGGT独立相关(P < 0.0001)。总之,在原发性高血压患者中,MBPS与血清GGT活性独立相关。这是文献中首次在该患者群体中证明两种新型心血管危险因素MBPS和血清GGT之间存在独立的剂量反应关系的研究。