Lindsay R S, Stewart M J, Nairn I M, Baird J D, Padfield P L
Department of Medicine, University of Edinburgh, Western General Hospital, UK.
J Hum Hypertens. 1995 Apr;9(4):223-7.
In essential hypertension reduced diurnal blood pressure (BP) variation is associated with an increased prevalence of target organ damage. We have examined diurnal BP variation in 25 microalbuminuric (MA) and 19 normoalbuminuric (NMA) patients with non-insulin-dependent diabetes and related albumin excretion rate (AER) to diurnal BP variation in the microalbuminuric group. There were no significant differences in age, body mass index (BMI), renal function, diabetic control, clinic or daytime ambulatory BP between the groups. Night-time SBP was higher (MA 145 mm Hg (137-153), NMA 132 mm Hg (125-139); P = 0.019) in the microalbuminuric group while the diurnal variation as assessed by the day-night dip in BP was significantly reduced in the microalbuminuric group (systolic: (mean (95% confidence intervals) MA 4.7% (1.7-7.7), NMA 12.8% (9.5-16.0), p = 0.001; diastolic: MA 6.5% (3.0-10.0), NMA 14.5% (10.2-18.8), P = 0.007). Within the microalbuminuric group, the systolic dip in BP was inversely related to the AER (r = -0.48, P = 0.015). Reduced diurnal BP variation and high night-time BP may contribute to target organ damage in diabetes.
在原发性高血压中，日间血压（BP）变异性降低与靶器官损害患病率增加相关。我们研究了25例微量白蛋白尿（MA）和19例正常白蛋白尿（NMA）的非胰岛素依赖型糖尿病患者的日间血压变异性，并将微量白蛋白尿组的白蛋白排泄率（AER）与日间血压变异性相关联。两组之间在年龄、体重指数（BMI）、肾功能、糖尿病控制情况、诊所血压或日间动态血压方面均无显著差异。微量白蛋白尿组夜间收缩压较高（MA为145 mmHg（137 - 153），NMA为132 mmHg（125 - 139）；P = 0.019），而通过血压昼夜差值评估的日间变异性在微量白蛋白尿组中显著降低（收缩压：（均值（95%置信区间）MA为4.7%（1.7 - 7.7），NMA为12.8%（9.5 - 16.0），p = 0.001；舒张压：MA为6.5%（3.0 - 10.0），NMA为14.5%（10.2 - 18.8），P = 0.007）。在微量白蛋白尿组内，血压收缩压差值与AER呈负相关（r = -0.48，P = 0.015）。日间血压变异性降低和夜间血压升高可能导致糖尿病患者的靶器官损害。
