Department of Cardiology, Tai'an Central Hospital, Tai'an, Shandong Province, China.
Eur Rev Med Pharmacol Sci. 2017 May;21(9):2226-2231.
The objective of the present study was to observe the relation between blood pressure variability (BPV) and early renal damage in hypertensive patients.
A total of 118 hypertensive patients were consecutively selected. General parameters including sex, age, duration, and grade of hypertension, antihypertensive drugs taken, smoking status, blood sugar, blood lipid level, body mass index, indexes of 24-h ambulatory blood pressure monitoring and renal function including cystatin C (CysC), serum creatinine (SCr), angiotensin II (Ang II), microalbuminuria (mALb), and urine creatinine (UCr) were measured. Glomerular filtration rate (eGFR), endogenous creatinine clearance rate (Ccr), and urine albumin/creatinine ratio (UACR) were calculated by CysC level, SCr level, and mALb and UCr level respectively. The 24-h ambulatory blood pressure monitoring indexes included 24-h mean systolic blood pressure variability (24h-SBPV), 24-h mean diastolic blood pressure variability (24h-DBPV), day mean systolic blood pressure variability (d-SBPV), day mean diastolic blood pressure variability (d-DBPV), night mean systolic blood pressure variability (n-SBPV), and night mean diastolic blood pressure variability (n-DBPV).
Sixty-four hypertensive patients (54.24%) were non-dipper, and the baseline data of the two groups were comparable. The 24h-SBPV, 24h-DBPV, d-DBPV, n-SBPV and SCr, eGFR, and Ccr of the two groups showed no significant differences. The d-SBPV, n-DBPV, CysC, and Ang II of the non-dipper group were significantly higher than those of the dipper group (p<0.05). The mALb in both groups increased and was more obvious in the non-dipper group. UACR of the non-dipper group was significantly higher than that of dipper group (p<0.05), while UCr showed no difference. By Pearson correlation, d-SBPV and n-DBPV correlated positively (p<0.05) with CysC, Ang II, mALb, and UACR.
BPV of hypersensitive patients, especially the d-SBPV and n-DBPV, was closely related to indexes of early renal damage including CysC, Ang II, mALb, and UACR.
本研究旨在观察高血压患者血压变异性（BPV）与早期肾损害之间的关系。
连续选取 118 例高血压患者，记录患者性别、年龄、病程、高血压分级、降压药物使用情况、吸烟情况、血糖、血脂水平、体质量指数，检测 24 h 动态血压监测指标及肾功能指标胱抑素 C（CysC）、血清肌酐（SCr）、血管紧张素 II（Ang II）、微量白蛋白尿（mALb）、尿肌酐（UCr），根据 CysC 水平、SCr 水平、mALb 和 UCr 水平分别计算肾小球滤过率（eGFR）、内生肌酐清除率（Ccr）和尿白蛋白/肌酐比值（UACR）。24 h 动态血压监测指标包括 24 h 平均收缩压变异性（24h-SBPV）、24 h 平均舒张压变异性（24h-DBPV）、日间平均收缩压变异性（d-SBPV）、日间平均舒张压变异性（d-DBPV）、夜间平均收缩压变异性（n-SBPV）、夜间平均舒张压变异性（n-DBPV）。
64 例（54.24%）高血压患者为非杓型，两组基线资料可比。两组 24h-SBPV、24h-DBPV、d-DBPV、n-SBPV 及 SCr、eGFR、Ccr 比较，差异无统计学意义；非杓型组 d-SBPV、n-DBPV、CysC、Ang II 明显高于杓型组（p<0.05），两组 mALb 均升高，且非杓型组升高更明显，非杓型组 UACR 明显高于杓型组（p<0.05），而 UCr 比较差异无统计学意义。Pearson 相关分析显示，d-SBPV、n-DBPV 与 CysC、Ang II、mALb、UACR 呈正相关（p<0.05）。
敏感患者的 BPV，尤其是 d-SBPV 和 n-DBPV，与 CysC、Ang II、mALb、UACR 等早期肾损害指标密切相关。
