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炎症性肠病患者夜间血压下降频率较高,但心率下降情况并非如此。

Higher Frequency of Nocturnal Blood Pressure Dipping but Not Heart Rate Dipping in Inflammatory Bowel Disease.

作者信息

Pourafkari Leili, Masnadi-Shirazi Kourosh, Taban Mohammadreza, Mohammadi Solmaz, Parizad Razieh, Ghaffari Samad, Tajlil Arezou, Khoshknab Mir Milad Pourmousavi, Nader Nader D

机构信息

Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Department of Anesthesiology, University at Buffalo, 77 Goodell Street, Suite #550, Buffalo, NY, 14203, USA.

出版信息

Dig Dis Sci. 2017 Oct;62(10):2863-2869. doi: 10.1007/s10620-017-4712-x. Epub 2017 Aug 23.

Abstract

BACKGROUND

Masked hypertension (MHTN) and lack of nocturnal dipping in blood pressure (BP) have been linked to the state of inflammation.

AIMS

We aimed to assess the frequency of nocturnal patterns of BP and heart rate (HR) in patients with IBD.

METHODS

Sixty-three normotensive patients with confirmed IBD during remission and 63 healthy subjects were enrolled in a case-control study. All subjects were monitored for BP and HR over a period of 24 h under ambulatory setting. Means for BP and HR were calculated for nighttime and daytime periods. Daytime BP ≥ 135/85 mmHg, nighttime BP ≥ 120/70 mmHg, and 24-h average BP ≥ 130/80 mmHg were defined as MHTN. The main end points of this study were lack of >10% nocturnal decrease in the systolic BP (NDP-BP) and in HR (NDP-HR).

RESULTS

After exclusion of 8 patients with IBD from analysis, 55 patients and 63 control subjects (49% men) with a mean age of 37.5 ± 11.0 years were enrolled. NDP-BP was more common in the IBD group compared to controls (55 vs. 33%; P = 0.026). MHTN was detected in 24% of IBD patients compared to 8% among controls (P = 0.017). Meanwhile, NDP-HR was observed in 22% of the IBD patients and 30% of the control group (P = 0.402). IBD remained a significant predictor of NDP-BP (odds ratio 2.60, 95% confidence interval 1.19-5.51) following an adjustment for age and gender.

CONCLUSIONS

IBD is associated with higher frequency of NDP-BP and MHTN; however, nocturnal changes in HR were similar in both groups.

摘要

背景

隐匿性高血压(MHTN)和夜间血压(BP)无勺型变化与炎症状态有关。

目的

我们旨在评估炎症性肠病(IBD)患者夜间血压和心率(HR)模式的频率。

方法

一项病例对照研究纳入了63例缓解期确诊为IBD的血压正常患者和63名健康受试者。所有受试者在动态环境下进行24小时的血压和心率监测。计算夜间和白天时段的血压和心率平均值。白天血压≥135/85 mmHg、夜间血压≥120/70 mmHg和24小时平均血压≥130/80 mmHg被定义为隐匿性高血压。本研究的主要终点是收缩压夜间下降幅度不足>10%(NDP-BP)和心率夜间下降幅度不足>10%(NDP-HR)。

结果

排除8例IBD患者后进行分析,纳入了55例患者和63名对照受试者(49%为男性),平均年龄为37.5±11.0岁。与对照组相比,NDP-BP在IBD组中更常见(55%对33%;P=0.026)。24%的IBD患者检测到隐匿性高血压,而对照组为8%(P=0.017)。同时,22%的IBD患者和30%的对照组观察到NDP-HR(P=0.402)。在对年龄和性别进行调整后,IBD仍然是NDP-BP的显著预测因素(优势比2.60,95%置信区间1.19-5.51)。

结论

IBD与NDP-BP和隐匿性高血压的较高频率相关;然而,两组的心率夜间变化相似。

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