Geriatric Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital.
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College.
Blood Press Monit. 2020 Dec;25(6):303-309. doi: 10.1097/MBP.0000000000000470.
Twenty-four-hour ambulatory blood pressure monitoring (ABPM) is an accurate method to document changes in blood pressure (BP) and is more predictive than office and home BP monitoring for cardiovascular outcomes in elderly people. We aimed to determine the relationship between ABPM indices and renal damage in elderly Chinese male patients with essential hypertension.
We investigated 998 Chinese men (mean age of 78.44 ± 12.02 years) with essential hypertension. Renal function, laboratory testing, and ABPM, including ABP, BP variability, and BP circadian rhythms were investigated. Data were shown according to BP controlling status. The relationships between ABPM indices and renal damage [expressed by urine protein, urine albumin/creatinine ratio (uACR), estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN)] were assessed using multiple regression analysis.
After adjustments for age, common cardiovascular risk factors, and medications, uACR level was positively associated with 24-h mean systolic blood pressure (SBP), 24-h mean pulse pressure (PP), and 24-h SBP percent time of elevation. eGFR level was negatively associated with the 24-h mean SBP and 24-h mean PP. BUN level was positively correlated with the 24-h mean SBP, 24-h mean PP, and 24-h SBP percent time of elevation, whereas the BUN level was negatively associated with the 24-h DBP SD.
The ABPM indices associated with renal damage may be regarded as an early predictive marker for renal function impairment in Chinese elderly male patients with hypertension.
24 小时动态血压监测（ABPM）是一种准确记录血压变化的方法，与诊室和家庭血压监测相比，其对老年人心血管结局的预测更为准确。本研究旨在探讨 24 小时动态血压监测指标与老年男性原发性高血压患者肾脏损害的关系。
本研究纳入了 998 例老年男性原发性高血压患者（平均年龄为 78.44±12.02 岁）。检测了患者的肾功能、实验室检查和 24 小时 ABPM，包括 ABPM、血压变异性和血压昼夜节律。根据血压控制情况进行数据分组。采用多元回归分析评估 ABPM 指标与肾脏损害[尿蛋白、尿白蛋白/肌酐比值（uACR）、估算肾小球滤过率（eGFR）、血尿素氮（BUN）]之间的关系。
校正年龄、常见心血管危险因素和药物后，uACR 水平与 24 小时平均收缩压（SBP）、24 小时平均脉压（PP）和 24 小时 SBP 升高时间百分比呈正相关。eGFR 水平与 24 小时平均 SBP 和 24 小时平均 PP 呈负相关。BUN 水平与 24 小时平均 SBP、24 小时平均 PP 和 24 小时 SBP 升高时间百分比呈正相关，而与 24 小时 DBP 标准差呈负相关。
与肾脏损害相关的 ABPM 指标可作为预测老年男性高血压患者肾功能损害的早期指标。
