Dai Siping, Huang Bo, Zou Yunliang, Liu Yan
Department of Emergency, The Third People's Hospital, Huizhou, China.
Arch Med Sci. 2019 Mar;15(2):337-342. doi: 10.5114/aoms.2018.72609. Epub 2018 Jan 5.
Dyslipidemia combined with hypertension increases the risk of cardiovascular disease (CVD). The current study aimed to investigate the association of dipping and non-dipping hypertension with CVD in patients with dyslipidemia.
A total of 243 documented dyslipidemia patients with hypertension were enrolled. Clinical characteristics and clinic and 24-hour blood pressure (BP) parameters were compared between dipping and non-dipping groups based on 24-hour ambulatory blood pressure monitoring. Logistic regression analysis was performed to evaluate the association of dipping and non-dipping hypertension with CVD.
Compared to the dipping group, patients in the non-dipping group were older, more likely to be male and smokers, had higher serum creatinine levels, and were more likely to have chronic kidney disease and CVD ( < 0.05 for all comparisons). No significant between-group differences in clinic systolic and diastolic BP (SBP and DBP) were observed. However, compared to the dipping group, 24-hour SBP, nighttime SBP and DBP, and night-day ratio of SBP and DBP were all significantly higher in the non-dipping group ( < 0.05 for all comparisons). In the dipping group, only night-day ratio of SBP was significantly associated with CVD, with an odds ratio (OR) of 1.09 (95% confidence interval (CI) of 1.02-1.34). In the non-dipping group, both night-day ratio of SBP and DBP were significantly associated with CVD, with an OR of 1.72 (95% CI: 1.33-2.06) and 1.23 (95% CI: 1.05-1.66), respectively.
In patients with dyslipidemia, non-dipping hypertension is more closely related to CVD compared to dipping hypertension.
血脂异常合并高血压会增加心血管疾病（CVD）的风险。本研究旨在探讨血脂异常患者中勺型和非勺型高血压与CVD的关联。
共纳入243例有记录的血脂异常合并高血压患者。基于24小时动态血压监测，比较勺型和非勺型组的临床特征以及诊室和24小时血压（BP）参数。进行逻辑回归分析以评估勺型和非勺型高血压与CVD的关联。
与勺型组相比，非勺型组患者年龄更大，更可能为男性且吸烟，血清肌酐水平更高，更可能患有慢性肾脏病和CVD（所有比较P<0.05）。未观察到两组间诊室收缩压和舒张压（SBP和DBP）有显著差异。然而，与勺型组相比，非勺型组的24小时SBP、夜间SBP和DBP以及SBP和DBP的夜间与日间比值均显著更高（所有比较P<0.05）。在勺型组中，仅SBP的夜间与日间比值与CVD显著相关，比值比（OR）为1.09（95%置信区间（CI）为1.02 - 1.34）。在非勺型组中，SBP和DBP的夜间与日间比值均与CVD显著相关，OR分别为1.72（95%CI：1.33 - 2.06）和1.23（95%CI：1.05 - 1.66）。
在血脂异常患者中，与勺型高血压相比，非勺型高血压与CVD的关系更为密切。
