Diminished circadian blood pressure variability in elderly individuals with nuclear cataracts: cross-sectional analysis in the HEIJO-KYO cohort
Diminished circadian blood pressure variability in elderly individuals with nuclear cataracts: cross-sectional analysis in the HEIJO-KYO cohort
复制标题
患有核性白内障的老年人的昼夜血压变异性降低：HEIJO-KYO 队列的横断面分析
DOI：
10.1038/s41440-018-0140-3
复制
发表时间：
2018
影响因子：
5.4
通讯作者：
Ogata Nahoko
中科院分区：
文献类型：
--
作者：
Yoshikawa Tadanobu;Obayashi Kenji;Miyata Kimie;Nishi Tomo;Ueda Tetsuo;Kurumatani Norio;Saeki Keigo;Ogata Nahoko
本研究旨在确定老年人白内障亚型与昼夜血压（BP）变异性之间的关系。在这项以社区为基础的横断面研究中，我们使用裂隙灯照片对458名老年人（平均年龄69.1岁）的双侧透镜混浊进行了评估。白内障状态定义为双侧透镜混浊分类系统III级≥3（核性白内障）、≥2（皮质性白内障）和≥2（后囊下白内障（PSC））。每隔30分钟进行一次动态血压监测，持续48小时。非杓型血压定义为夜间平均收缩压相对于白天平均收缩压下降<10%。在有核性白内障组（n= 66）和无白内障组（n= 290）中，非杓型模式的患病率分别为42.4%和25.9%。校正潜在混杂因素后的多变量logistic回归分析显示，核性白内障组非勺型的优势比（OR）显著高于无白内障组（OR，1.81; 95%置信区间，1.01-3.24;P= 0.047），但皮质性白内障组（P= 0.61）或PSC组（P= 0.95）则无此差异。总之，昼夜血压变异性显着减少，在老年人核性白内障，但没有在皮质性白内障或PSC。这些关联与白天的光照、体力活动和已知的白内障风险因素（如衰老、肥胖和糖尿病）无关。
The present study aimed to determine the relationship between cataract subtypes and circadian blood pressure (BP) variability in elderly individuals. In this cross-sectional study of a community-based cohort, we assessed bilateral lens opacity using slit lamp photographs of 458 elderly individuals (mean age, 69.1 years). Cataract status was defined as a bilateral Lens Opacities Classification System III grade of ≥3 for nuclear cataract, ≥2 for cortical cataract, and ≥2 for posterior subcapsular cataract (PSC). Ambulatory BP monitoring was performed at 30-min intervals for 48 h. A nondipper pattern of BP was defined as a <10% decline in the mean nighttime systolic BP relative to the mean daytime systolic BP. The prevalence of nondipper patterns was 42.4% and 25.9% in the groups with nuclear cataracts (n= 66) and without cataracts for both eyes (n= 290), respectively. Multivariable logistic regression analysis adjusted for potential confounders revealed a significantly higher odds ratio (OR) for nondipper pattern in the group with nuclear cataract than in that without cataract (OR, 1.81; 95% confidence interval, 1.01–3.24;P= 0.047) but not in the group with cortical cataract (P= 0.61) or PSC (P= 0.95). In conclusion, circadian BP variability was significantly diminished in elderly individuals with nuclear cataracts but not in those with cortical cataracts or PSCs. These associations were independent of daytime light exposure, physical activity, and known risk factors of cataracts, such as aging, obesity, and diabetes.