Huang Jia-Ying, Zheng Wang, Feng Xin-Di, Qiao Si-Yu, Tang Jing-Yi, Ma Zi-Lin, Wang Feng, Wei Yi-Hong
Department of Traditional Chinese Medicine, Tianshan Community Healthcare Center, Shanghai, People's Republic of China.
Cardiology Department, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
Vasc Health Risk Manag. 2025 Sep 5;21:759-771. doi: 10.2147/VHRM.S540403. eCollection 2025.
Few studies have explored the link between body fluid ion levels (sodium, calcium, magnesium, phosphorus) and blood pressure circadian rhythm. This study investigates these ions' relationship with the dipping blood pressure pattern in hypertensive patients, highlighting their potential for monitoring electrolyte levels in hypertension management.
According to 2018 Chinese guidelines for hypertension management, hypertensive patients were classified into dipping/super-dipping and non-dipping/reverse-dipping groups based on nocturnal blood pressure decline. Clinical data and serum/24-hour urine electrolyte levels were then collected from these patients. Logistic regression and advanced statistical modeling were used to identify influencing factors.
Age and alpha-blockers negatively correlate with the likelihood of dipping blood pressure in hypertensive patients (P<0.05). Highest chance of dipping occurs at age 54 years, with serum sodium at 139.55 mmol/L and 24-hour urinary calcium at 5.34 mmol (P<0.05). The lowest likelihood is at a 24-hour urinary calcium level of 1.65 mmol (P<0.05). The largest nocturnal systolic drop is at age 57 years, serum calcium at 2.41 mmol/L, and 24-hour urinary calcium at 5.34 mmol (P<0.05). The largest diastolic drop is at age 54 years, with serum sodium at 139.03 mmol/L, serum calcium at 2.42 mmol/L, and serum magnesium at 0.95 mmol/L (P<0.05). A serum calcium level over 2.20 mmol/L significantly boosts the chance of dipping and nocturnal diastolic drop (P<0.05).
In hypertensive patients, the chance of a dipping blood pressure pattern declines with age, possibly peaking between 54-57 years. Optimal serum sodium for dipping is 139 mmol/L, and higher serum calcium (peaking at 2.41 mmol/L) increases this likelihood. Alpha-blockers may negatively affect the dipping blood pressure pattern.
很少有研究探讨体液离子水平（钠、钙、镁、磷）与血压昼夜节律之间的联系。本研究调查了这些离子与高血压患者血压勺型模式的关系，强调了它们在高血压管理中监测电解质水平的潜力。
根据2018年中国高血压管理指南，根据夜间血压下降情况将高血压患者分为勺型/超勺型和非勺型/反勺型组。然后收集这些患者的临床资料和血清/24小时尿电解质水平。采用逻辑回归和高级统计模型来确定影响因素。
年龄和α受体阻滞剂与高血压患者血压勺型的可能性呈负相关（P<0.05）。勺型出现的最高几率出现在54岁，血清钠为139.55 mmol/L，24小时尿钙为5.34 mmol（P<0.05）。最低几率出现在24小时尿钙水平为1.65 mmol时（P<0.05）。最大夜间收缩压下降出现在57岁，血清钙为2.41 mmol/L，24小时尿钙为5.34 mmol（P<0.05）。最大舒张压下降出现在54岁，血清钠为139.03 mmol/L，血清钙为2.42 mmol/L，血清镁为0.95 mmol/L（P<0.05）。血清钙水平超过2.20 mmol/L显著增加了勺型和夜间舒张压下降的几率（P<0.05）。
在高血压患者中，血压勺型模式的几率随年龄下降可能在54 - 57岁之间达到峰值。勺型的最佳血清钠为139 mmol/L，较高的血清钙（峰值为2.41 mmol/L）会增加这种可能性。α受体阻滞剂可能对血压勺型模式产生负面影响。
