Celik Gulperi, Yilmaz Sema, Ergulu Esmen Serpil
Division of Nephrology, Department Of Internal Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey.
Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey.
Hypertens Res. 2015 Dec;38(12):856-61. doi: 10.1038/hr.2015.86. Epub 2015 Aug 13.
Behcet's disease is a multisystemic vasculitis involving veins and arteries of various sizes. Non-dipping status, augmentation index and pulse wave velocity are important determinants of cardiovascular mortality and morbidity. We investigated the non-dipping status and arterial stiffness in patients with Behcet's disease. In this cross-sectional study, we examined the vascular parameters of 96 patients with Behcet's disease (53% female) and 60 age- and sex-matched control subjects. The non-dipping status and arterial distensibility were assessed using a Mobil-O-Graph Arteriograph, an automatic oscillometric device. In total, 65.6% of 96 patients were systolic non-dippers, and 34.4% exhibited high augmentation indices. Ten percent of the control subjects were systolic non-dippers, and 11.7% exhibited high augmentation indices. Nocturnal decreases in systolic blood pressure correlated with central systolic blood pressure and diastolic blood pressure, as well as nocturnal decreases in diastolic blood pressure. Furthermore, non-dipper patients with Behcet's disease exhibited higher nocturnal cardiac outputs than did dipper patients with Behcet's disease. Augmentation index correlated negatively with C-reactive protein and correlated positively with both 24 h and nocturnal peripheral resistance, as well as 24 h pulse wave velocity. The patients with high augmentation indices exhibited lower creatinine clearance, as well as lower nocturnal cardiac outputs, higher 24 h peripheral resistance and higher 24 h pulse wave velocities. Non-dipping status and arterial stiffness may exacerbate the harmful cardiovascular effects of the other. In addition to conventional risk factors, non-dipping status and arterial stiffness should be examined during the follow-up evaluations of patients with Behcet's disease.
白塞病是一种累及不同大小动静脉的多系统血管炎。血压非勺型状态、增强指数和脉搏波速度是心血管疾病死亡率和发病率的重要决定因素。我们对白塞病患者的血压非勺型状态和动脉僵硬度进行了研究。在这项横断面研究中,我们检查了96例白塞病患者(53%为女性)以及60名年龄和性别匹配的对照者的血管参数。使用Mobil - O - Graph动脉记录仪(一种自动示波装置)评估血压非勺型状态和动脉扩张性。96例患者中,65.6%为收缩压非勺型者,34.4%表现出高增强指数。对照者中10%为收缩压非勺型者,11.7%表现出高增强指数。夜间收缩压下降与中心收缩压和舒张压相关,也与夜间舒张压下降相关。此外,白塞病非勺型患者的夜间心输出量高于白塞病勺型患者。增强指数与C反应蛋白呈负相关,与24小时和夜间外周阻力以及24小时脉搏波速度呈正相关。增强指数高的患者肌酐清除率较低,夜间心输出量较低,24小时外周阻力较高,24小时脉搏波速度较高。血压非勺型状态和动脉僵硬度可能会加重彼此对心血管的有害影响。除了传统危险因素外,在对白塞病患者的随访评估中还应检查血压非勺型状态和动脉僵硬度。