Cao Gao-Zhen, Huang Jia-Yi, Lin Qing-Shan, Wang Run, Chen Cong, Xiu Jian-Cheng, Yiu Kai-Hang
The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Division of Cardiovascular Medicine, Cardiac and Vascular Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
J Clin Hypertens (Greenwich). 2025 Feb;27(2):e14979. doi: 10.1111/jch.14979.
This study aimed to investigate the associations between 24-hour urinary cortisol levels (24 h-UFC) and alterations in left ventricular (LV) structure and function in patients with essential hypertension. A prospective cohort study was conducted, including 315 patients with essential hypertension who underwent baseline 24 h-UFC measurement and echocardiographic evaluation of left ventricular mass (LVM), left ventricular ejection fraction (LVEF), and the E/e' ratio. Over a mean follow-up period of 28.54 ± 14.21 months, patients were grouped into tertiles based on baseline 24 h-UFC levels. Higher baseline 24 h-UFC levels were significantly associated with greater increases in LVM and E/e', reflecting adverse LV remodeling and diastolic dysfunction. These associations persisted after adjusting for potential confounders, including age, gender, baseline blood pressure, and their changes during follow-up. Moreover, patients in the highest 24 h-UFC tertile showed an increased prevalence of LV hypertrophy, contrasting with a reduction observed in the lower tertiles. These findings underscore the independent role of elevated 24 h-UFC levels in driving adverse cardiac structural and functional changes in essential hypertension.
本研究旨在探讨原发性高血压患者24小时尿皮质醇水平（24 h-UFC）与左心室（LV）结构及功能改变之间的关联。进行了一项前瞻性队列研究，纳入315例原发性高血压患者，这些患者接受了基线24 h-UFC测量以及左心室质量（LVM）、左心室射血分数（LVEF）和E/e'比值的超声心动图评估。在平均28.54±14.21个月的随访期内，根据基线24 h-UFC水平将患者分为三分位数组。较高的基线24 h-UFC水平与LVM和E/e'的更大增加显著相关，反映了不良的左心室重构和舒张功能障碍。在调整了包括年龄、性别、基线血压及其随访期间变化等潜在混杂因素后，这些关联仍然存在。此外，24 h-UFC三分位数最高组的患者左心室肥厚患病率增加，而较低三分位数组则观察到患病率降低。这些发现强调了24 h-UFC水平升高在驱动原发性高血压患者不良心脏结构和功能变化中的独立作用。
