Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Department of Gastrointestinal Oncology Surgery, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Endocrine. 2024 Nov;86(2):834-840. doi: 10.1007/s12020-024-03955-5. Epub 2024 Jul 17.
To investigate the association between blood pressure (BP) time in range (TIR) and composite cardiovascular outcomes in patients with primary aldosteronism (PA).
Between January 2019 and December 2021, 47 patients with PA were recruited from the First Affiliated Hospital of Xiamen University. Twenty-four-hour ambulatory BP monitoring (ABPM) and cardiovascular outcomes were assessed in all patients during the first diagnosis of PA.
The mean age of the patients was 48.8 ± 11.4 years. Compared to PA without composite cardiovascular outcomes, the nighttime systolic BP TIR [31.2% (6.2%, 81.2%) vs. 11.5% (0.0%, 29.7%), p = 0.02] and defined daily dose (DDDs) of antihypertensive medication [2.0 (1.0, 2.8) vs. 1.0 (1.0, 2.0), p = 0.03] were lower in PA patients with composite cardiovascular outcomes, while higher glucose (5.0 ± 1.0 mmol/L vs. 5.9 ± 1.5 mmol/L) and prevalence of a history of alcohol intake was higher in PA patients with composite cardiovascular outcomes. There were no differences in age, sex, BMI, smoking, duration of hypertension, lipid levels, aldosteronism, clinic BP, 24-hour mean BP, daytime or nighttime BP, percentage of nocturnal SBP or DBP decline, 24-hour BP TIR, daytime BP TIR, or nighttime DBP TIR between the two groups. After adjusting for confounding factors, nighttime systolic BP TIR was significantly associated with composite cardiovascular outcomes (adjusted OR = 0.92 [95% CI 0.86, 0.99]) in multiple logistic regression analysis.
Nighttime systolic BP TIR was significantly associated with composite cardiovascular outcomes in patients with PA.
探讨原发性醛固酮增多症（PA）患者血压达标时间（TIR）与复合心血管结局的关系。
2019 年 1 月至 2021 年 12 月，从厦门大学附属第一医院招募了 47 例 PA 患者。所有患者在首次诊断为 PA 时均进行 24 小时动态血压监测（ABPM）和心血管结局评估。
患者的平均年龄为 48.8±11.4 岁。与无复合心血管结局的 PA 患者相比，复合心血管结局的 PA 患者夜间收缩压 TIR [31.2%（6.2%，81.2%）比 11.5%（0.0%，29.7%），p=0.02]和降压药物的定义日剂量（DDD）[2.0（1.0，2.8）比 1.0（1.0，2.0），p=0.03]较低，而血糖（5.0±1.0 mmol/L 比 5.9±1.5 mmol/L）和饮酒史的发生率较高。两组在年龄、性别、BMI、吸烟、高血压病程、血脂水平、醛固酮、诊室血压、24 小时平均血压、日间或夜间血压、夜间收缩压下降百分比、24 小时血压 TIR、日间血压 TIR 或夜间舒张压 TIR 等方面均无差异。在调整混杂因素后，多因素 logistic 回归分析显示夜间收缩压 TIR 与复合心血管结局显著相关（调整 OR=0.92[95%CI 0.86，0.99]）。
夜间收缩压 TIR 与 PA 患者的复合心血管结局显著相关。
