Ozal Ender, Sahin Irfan, Bolat Ismail, Pusuroglu Hamdi, Avci Ilhan Iker, Akgul Ozgur, Ornek Vesile, Sürgit Ozgür, Yildirim Aydin
aDepartment of Cardiology, Bagcilar Research and Education Hospital bDepartment of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital cDepartment of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center dDepartment of Biochemistry, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul eDepartment of Cardiology, Department of Cardiology, Fethiye State Hospital, Muğla, Turkey.
Blood Press Monit. 2017 Jun;22(3):137-142. doi: 10.1097/MBP.0000000000000245.
The aim of this study was to investigate the possible correlation of serum visfatin levels with resistant hypertension (RHT).
Patients who had undergone ambulatory blood pressure measurements (ABPM) during the outpatient controls were prospectively recruited. Seventy-one patients with RHT and 94 patients with controlled hypertension (CHT) were included in the study. RHT was defined as 'uncontrolled blood pressure (BP) despite using three antihypertensive agents including a diuretic or need of four or more drugs to control BP'. The demographic properties, medications used, and laboratory parameters including visfatin levels were recorded.
In the RHT group, left ventricular mass index was significantly higher compared with the CHT group (108.13±26.86 vs. 89.46±24.09 g/m, P<0.01). High-sensitivity C-reactive protein and visfatin levels were significantly higher in the RHT group [4.0 (5.2) vs. 2.3 (3.0) mg/l, P<0.01, and 12.87±4.98 vs. 9.46±4.69 ng/ml, P<0.01, respectively] compared with the CHT group. In the multivariate linear regression model, visfatin level remained as an independent predictor for office systolic BP [B: 2.07, 95% confidence interval (CI): 1.17-2.98, P<0.01]; office diastolic BP (B: 0.71, 95% CI: 0.27-1.16, P<0.01); mean 24-h systolic ABPM (B: 1.46, 95% CI: 0.79-2.13, P<0.01); and mean 24-h diastolic ABPM (B: 0.88, 95% CI: 0.42-1.34, P<0.01) and was also correlated independently with left ventricular mass index (B: 3.13, 95% CI: 2.58-3.99, P<0.01).
In this cohort of RHT patients diagnosed with ABPM, we have found an independent correlation between higher visfatin levels and the presence of RHT and left ventricular hypertrophy.
本研究旨在探讨血清内脂素水平与难治性高血压（RHT）之间可能存在的相关性。
前瞻性招募在门诊控制期间接受动态血压测量（ABPM）的患者。研究纳入了71例难治性高血压患者和94例血压控制良好的高血压（CHT）患者。难治性高血压被定义为“尽管使用了包括利尿剂在内的三种抗高血压药物，血压仍未得到控制，或需要四种或更多药物来控制血压”。记录人口统计学特征、使用的药物以及包括内脂素水平在内的实验室参数。
在难治性高血压组中，左心室质量指数显著高于血压控制良好的高血压组（108.13±26.86 vs. 89.46±24.09 g/m²，P<0.01）。与血压控制良好的高血压组相比，难治性高血压组的高敏C反应蛋白和内脂素水平显著更高[分别为4.0（5.2）vs. 2.3（3.0）mg/l，P<0.01，以及12.87±4.98 vs. 9.46±4.69 ng/ml，P<0.01]。在多元线性回归模型中，内脂素水平仍然是诊室收缩压的独立预测因子[B：2.07，95%置信区间（CI）：1.17 - 2.98，P<0.01]；诊室舒张压（B：0.71，95%CI：0.27 - 1.16，P<0.01）；24小时平均收缩压ABPM（B：1.46，95%CI：0.79 - 2.13，P<0.01）；以及24小时平均舒张压ABPM（B：0.88，95%CI：0.42 - 1.34，P<0.01），并且还与左心室质量指数独立相关（B：3.13，95%CI：2.58 - 3.99，P<0.01）。
在这组通过ABPM诊断的难治性高血压患者中，我们发现较高的内脂素水平与难治性高血压和左心室肥厚的存在之间存在独立相关性。
