Zhang Xin, Ye Runyu, Yang Xiangyu, Li Xinran, Zhang Zhipeng, Meng Qingtao, Chen Xiaoping
Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China.
Hypertens Res. 2025 Sep 1. doi: 10.1038/s41440-025-02350-5.
Ambulatory blood pressure monitoring (ABPM) studies for high altitude (HA) hypertensive patients are limited. We aimed to explore the hypertension phenotypes, and investigate their associations with hemoglobin in untreated hypertensives permanently living in HA. A total of 342 untreated hypertensive patients were included. Among the whole population, 91.80% had sustained hypertension (SH). In patients with SH, the proportions of isolated daytime hypertension, isolated nocturnal hypertension, and day-night hypertension were 2.87%, 2.87%, and 94.26%, respectively. Compared to patients with hemoglobin ≥16 g/dL, those with hemoglobin <16 g/dL had higher nocturnal average systolic blood pressure (SBP) (140.33 ± 17.46 vs. 136.26 ± 17.55 mmHg, P = 0.03) and a greater proportion of patients with nocturnal SBP fall<10% (55.00% vs. 43.30%, P = 0.03). Bivariate correlation analysis showed that hemoglobin was negatively correlated with the nocturnal average SBP (r = -0.145, P < 0.01) and was positively related to the nocturnal SBP fall (r = 0.136, P = 0.01). We found that the threshold effect value between hemoglobin and nocturnal blood pressure indices was 16 g/dL. The effect value between hemoglobin and nocturnal average SBP was -3.60 (-5.46, -1.74) for hemoglobin <16 g/dL and 0.88 (-1.07, 2.83) for hemoglobin ≥16 g/dL. Correspondingly, the effect values between hemoglobin and nocturnal SBP fall were 1.53 (0.61, 2.45) and -0.26 (-1.23, 0.70). In addition, hemoglobin was independently correlated with the above-mentioned nocturnal blood pressure indices in those with hemoglobin <16 g/dL. In conclusion, nocturnal hypertension was a prevalent ABPM phenotype in HA hypertensive patients. In those with hemoglobin levels <16 g/dL, hemoglobin concentration shows a significant inverse correlation with nocturnal SBP, suggesting that lower hemoglobin levels may warrant enhanced evaluation of nocturnal BP in this population.
针对高原（HA）高血压患者的动态血压监测（ABPM）研究有限。我们旨在探索高血压表型，并调查长期居住在高原地区的未治疗高血压患者中这些表型与血红蛋白的关联。共纳入342例未治疗的高血压患者。在整个人群中，91.80%患有持续性高血压（SH）。在SH患者中，单纯日间高血压、单纯夜间高血压和昼夜高血压的比例分别为2.87%、2.87%和94.26%。与血红蛋白≥16 g/dL的患者相比，血红蛋白<16 g/dL的患者夜间平均收缩压（SBP）更高（140.33±17.46 vs. 136.26±17.55 mmHg，P = 0.03），且夜间SBP下降<10%的患者比例更高（55.00% vs. 43.30%，P = 0.03）。双变量相关性分析显示，血红蛋白与夜间平均SBP呈负相关（r = -0.145，P < 0.01），与夜间SBP下降呈正相关（r = 0.136，P = 0.01）。我们发现血红蛋白与夜间血压指标之间的阈值效应值为16 g/dL。血红蛋白<16 g/dL时，血红蛋白与夜间平均SBP之间的效应值为-3.60（-5.46，-1.74），血红蛋白≥16 g/dL时为0.88（-1.07，2.83）。相应地，血红蛋白与夜间SBP下降之间的效应值分别为1.53（0.61，2.45）和-0.26（-1.23，0.70）。此外，在血红蛋白<16 g/dL的患者中，血红蛋白与上述夜间血压指标独立相关。总之，夜间高血压是高原高血压患者中一种常见的ABPM表型。在血红蛋白水平<16 g/dL的患者中，血红蛋白浓度与夜间SBP呈显著负相关，这表明在该人群中较低的血红蛋白水平可能需要加强对夜间血压的评估。
