Wang Cheng, Deng Wen-Jie, Gong Wen-Yu, Zhang Jun, Tang Hua, Peng Hui, Zhang Qun-Zi, Ye Zeng-Chun, Lou Tanqi
Division of Nephrology, Department of Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (C.W., W.J.D., W.Y.G., J.Z., H.T., H.P., Q.Z.Z., Z.C.Y., T.L.).
J Am Heart Assoc. 2015 Jun 18;4(6):e002025. doi: 10.1161/JAHA.115.002025.
Isolated nocturnal hypertension (INH) has been studied among the general population and hypertensive patients. However, little insight is available on the prevalence of INH and its role in target-organ damage among patients with chronic kidney disease (CKD).
We recruited 1282 CKD patients admitted to our hospital division. Patients were divided into 4 groups: INH; isolated daytime hypertension; day-night sustained; and ambulatory normotension. Multiple linear regression analyses were used to evaluate the correlation between INH and renal/cardiovascular parameters. A total of 262 (20.44%) CKD patients had isolated nocturnal hypertension and 651 (50.78%) had day-night sustained hypertension, whereas only 350 (27.30%) patients showed normotension and 19 (1.48%) had isolated daytime hypertension. Multivariate logistic regression analysis showed that INH was associated mainly with age, estimated glomerular filtration rate, clinic diastolic blood pressure, and that INH was determined only by age, estimated glomerular filtration rate, and clinic diastolic blood pressure. The prevalence of impaired renal function, left ventricular hypertrophy, and carotid intima-media thickness in patients with INH were higher than in normotensive patients (P<0.05), whereas impaired renal function and left ventricular hypertrophy in these patients were lower than patients in the day-night sustained hypertension group (P<0.05). INH was correlated with estimated glomerular filtration rate, left ventricular mass index, and carotid intima-media thickness according to multiple linear regression analyses.
The prevalence of INH in CKD patients was high, and INH was correlated with target-organ damage in CKD patients.
普通人群和高血压患者中已对单纯夜间高血压（INH）进行了研究。然而，关于慢性肾脏病（CKD）患者中INH的患病率及其在靶器官损害中的作用，目前了解甚少。
我们招募了1282名入住我院科室的CKD患者。患者被分为4组：INH组；单纯日间高血压组；昼夜持续高血压组；动态血压正常组。采用多元线性回归分析评估INH与肾脏/心血管参数之间的相关性。共有262名（20.44%）CKD患者患有单纯夜间高血压，651名（50.78%）患有昼夜持续高血压，而只有350名（27.30%）患者血压正常，19名（1.48%）患有单纯日间高血压。多因素logistic回归分析显示，INH主要与年龄、估算肾小球滤过率、诊室舒张压相关，且INH仅由年龄、估算肾小球滤过率和诊室舒张压决定。INH患者肾功能受损、左心室肥厚和颈动脉内膜中层厚度的患病率高于血压正常患者（P<0.05），而这些患者的肾功能受损和左心室肥厚低于昼夜持续高血压组患者（P<0.05）。根据多元线性回归分析，INH与估算肾小球滤过率、左心室质量指数和颈动脉内膜中层厚度相关。
CKD患者中INH的患病率较高，且INH与CKD患者的靶器官损害相关。
