Koike Tsutomu, Imamura Teruhiko, Tomoda Fumihiro, Ohara Maiko, Fujioka Hayato, Kakeshita Kota, Yamazaki Hidenori, Kinugawa Koichiro
Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.
Faculty of Health Science, Fukui Health Science University, Fukui 910-3190, Japan.
J Clin Med. 2023 Jan 10;12(2):570. doi: 10.3390/jcm12020570.
Background: In patients with essential hypertension, a non-dipping blood pressure pattern is a strong risk factor for cardiovascular diseases. However, background factors associating with such a blood pressure pattern remain unknown. Methods: Untreated essential hypertensive patients without chronic kidney diseases who were admitted to our outpatient clinic were included. Blood sampling and 24 h ambulatory blood pressure monitoring were mandatorily performed. Non-dipper status was defined as a maximum decrease in nocturnal systolic blood pressure within 10%. Clinical factors associating with non-dipper status were investigated. Results: A total of 154 patients (56 ± 12 years old, 86 men) were included. Among baseline characteristics, a higher serum uric acid level was independently associated with non-dipper status (odds ratio 1.03, 95% confidence interval 1.00−1.05, p < 0.05). Among those with non-dipper status, a higher high-sensitivity C-reactive protein level tended to be associated with incremental nighttime systolic blood pressure levels (p = 0.065). Conclusions: Hyperuricemia and micro-inflammation might be associated with attenuated nocturnal blood pressure dipping and incremental nighttime systolic blood pressure levels.
在原发性高血压患者中,血压非勺型模式是心血管疾病的一个重要危险因素。然而,与这种血压模式相关的背景因素仍然未知。方法:纳入我院门诊收治的未经治疗的无慢性肾脏病的原发性高血压患者。强制进行血液采样和24小时动态血压监测。非勺型状态定义为夜间收缩压最大降幅在10%以内。研究与非勺型状态相关的临床因素。结果:共纳入154例患者(56±12岁,86例男性)。在基线特征中,较高的血清尿酸水平与非勺型状态独立相关(比值比1.03,95%置信区间1.00−1.05,p<0.05)。在非勺型状态患者中,较高的高敏C反应蛋白水平倾向于与夜间收缩压水平升高相关(p=0.065)。结论:高尿酸血症和微炎症可能与夜间血压降幅减弱及夜间收缩压水平升高有关。