Xie Nianjin, Li Xida, Zhong Qi, Zhou Dan, Cai Anping, Zhang Ying, Zhou Yingling, Feng Yingqing
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Arch Med Sci. 2019 Jul;15(4):832-836. doi: 10.5114/aoms.2018.77727. Epub 2018 Aug 23.
To investigate the association between blood pressure components and microalbuminuria (MAU) in newly diagnosed and treatment-naïve hypertensive patients.
A total of 1858 newly diagnosed and treatment-naïve hypertensive patients were enrolled. Based on 24 h urine albumin concentration, all patients were divided into MAU and normo-albuminuria groups. The associations between blood pressure (BP) components, namely systolic/diastolic BP (SBP/DBP) and pulse pressure (PP) and MAU, as well as the sensitivity and specificity of each BP component in predicting MAU, were evaluated.
Compared to the normo-albuminuria group, patients in the MAU group were older and had significantly higher SBP and PP ( < 0.05). Serum levels of fasting blood glucose, total protein and creatinine were significantly higher in the MAU group ( < 0.05). 24-hour urine albumin excretion was significantly higher in the MAU group than the normo-albuminuria group (182.5 ±156.5 mg vs. 17.6 ±7.1 mg, < 0.001). Logistic regression analyses revealed that SBP and PP were significantly associated with MAU, with an odds ratio (OR) of 1.010 (95% confidence interval (CI): 1.005-1.016, < 0.001) in SBP and OR of 1.009 (95% CI: 1.003-1.015, = 0.003) in PP. The receiver operating characteristic curve showed that the area under the curve for SBP to predict MAU was 0.541 ±0.013, and PP was 0.536 ±0.013. The difference in predicting MAU by SBP or PP was non-significant.
In newly diagnosed and treatment-naïve hypertensive patients, increased SBP and PP were independently associated with MAU.
探讨初诊未治疗高血压患者血压各组分与微量白蛋白尿（MAU）之间的关联。
共纳入1858例初诊未治疗高血压患者。根据24小时尿白蛋白浓度，将所有患者分为MAU组和正常白蛋白尿组。评估血压（BP）各组分，即收缩压/舒张压（SBP/DBP）和脉压（PP）与MAU之间的关联，以及各血压组分预测MAU的敏感性和特异性。
与正常白蛋白尿组相比，MAU组患者年龄更大，SBP和PP显著更高（<0.05）。MAU组空腹血糖、总蛋白和肌酐的血清水平显著更高（<0.05）。MAU组24小时尿白蛋白排泄量显著高于正常白蛋白尿组（182.5±156.5mg对17.6±7.1mg，<0.001）。逻辑回归分析显示，SBP和PP与MAU显著相关，SBP的比值比（OR）为1.010（95%置信区间（CI）：1.005 - 1.016，<0.001），PP的OR为1.009（95%CI：1.003 - 1.015，=0.003）。受试者工作特征曲线显示，SBP预测MAU的曲线下面积为0.541±0.013，PP为0.536±0.013。SBP或PP预测MAU的差异无统计学意义。
在初诊未治疗高血压患者中，SBP和PP升高与MAU独立相关。
