Koska-Ścigała Agata, Jankowska Magdalena, Szyndler Anna, Narkiewicz Krzysztof, Dębska-Ślizień Alicja
Department of Neurology, Regional Hospital in Elbląg, Poland.
Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Poland.
Adv Clin Exp Med. 2022 May;31(5):575-578. doi: 10.17219/acem/149373.
Pulse pressure (PP) is a pulsatile component of blood pressure (BP), strongly correlated with arterial stiffness (AS) and impacting prognosis. Disproportionally increased PP values in individuals with autosomal dominant polycystic kidney disease (ADPKD) should be expected, given the multifactorial cardiovascular involvement in the natural course of this disease.
To investigate ambulatory PP in a group of ADPKD patients, and to examine the impact of age, sex, kidney function, hypertension, circadian rhythm, and antihypertensive drugs (AH) on studied parameters.
A total of 130 ADPKD patients (median age 41 years, 35% men) who underwent 24-hour BP measurement with portable oscillometer Spacelabs 90217, were included in the study and their recordings were retrospectively analyzed. Demographic data and the medical history including antihypertensive treatment were collected, ADPKD was diagnosed based on the criteria by Pei et al., and estimated glomerular filtration rate (eGFR) was calculated according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.
Pulse pressure in the whole group was 46 (IQR: 42-53) mm Hg and it was significantly higher in men than in women and during the day compared to nighttime. There was a negative correlation of PP with eGFR and a positive correlation with age. Pulse pressure was not different in ADPKD patients with or without a diagnosis of hypertension.
Ambulatory PP is not substantially increased in ADPKD patients across different stages of CKD. It follows a regular pattern of being increased with age, male sex, daytime, and decreasing eGFR, but not with the diagnosis of hypertension.
脉压（PP）是血压（BP）的搏动成分，与动脉僵硬度（AS）密切相关且影响预后。鉴于常染色体显性多囊肾病（ADPKD）自然病程中的多因素心血管受累情况，预计该疾病患者的PP值会不成比例地升高。
研究一组ADPKD患者的动态PP，并考察年龄、性别、肾功能、高血压、昼夜节律和抗高血压药物（AH）对研究参数的影响。
本研究纳入了130例ADPKD患者（中位年龄41岁，35%为男性），这些患者使用便携式示波仪Spacelabs 90217进行了24小时血压测量，并对其记录进行回顾性分析。收集了人口统计学数据和包括抗高血压治疗在内的病史，根据裴等人的标准诊断ADPKD，并根据慢性肾脏病流行病学协作组（CKD-EPI）方程计算估算肾小球滤过率（eGFR）。
全组脉压为46（四分位间距：42 - 53）mmHg，男性显著高于女性，白天高于夜间。PP与eGFR呈负相关，与年龄呈正相关。有或无高血压诊断的ADPKD患者脉压无差异。
在CKD不同阶段的ADPKD患者中，动态PP没有显著升高。它呈现出随年龄、男性、白天增加以及eGFR降低而升高的规律模式，但与高血压诊断无关。
