Ambulatory blood pressure and heart rate in hypertensives with renal failure: Comparison between diabetic nephropathy and non-diabetic glomerulopathy
Ambulatory blood pressure and heart rate in hypertensives with renal failure: Comparison between diabetic nephropathy and non-diabetic glomerulopathy
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DOI：
10.1080/10641960701813890
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发表时间：
2008-01-01
影响因子：
12.3
通讯作者：
Umemura, Satoshi
中科院分区：
文献类型：
--
作者：
Tamura, Kouichi;Yamauchi, Junji;Umemura, Satoshi
本研究的目的是检查患有糖尿病肾病 (DN) 的高血压患者和患有非糖尿病肾病 (non-DN) 的高血压患者 24 小时血压 (BP) 曲线可能存在的差异。我们测量了 34 名 2 型 DN 患者和 34 名非 DN 患者的 24 小时动态血压，这些患者因教育项目而住院。 DN（24 小时收缩压为 143 与 136 mmHg，NS）和非 DN（日间收缩压为 143 与 138 mmHg，NS）之间的 24 小时和白天收缩压没有显着差异。尽管两组均显示夜间血压下降迟缓，并被归类为“非杓状”型，但 DN 患者的夜间收缩压显着高于非 DN 患者（142 毫米汞柱 vs. 132 毫米汞柱，p = 0.0217）。还估计了血压和心率 (HR) 变异性，DN 患者的夜间 HR 变异性比非 DN 患者低（4.8 次/分钟与 6.6 次/分钟，p = 0.0115）。 DN 患者尿蛋白排泄量增加（3.0 vs. 1.4 g/天，p = 0.0095），血清白蛋白浓度降低（3.1 vs. 3.7 mg/dl，p < 0.0001）。此外，尿蛋白排泄量与夜间收缩压显着相关（r = 0.480，p = 0.0031），但与夜间心率变异性无关。综上所述，这些结果表明血压和心率的昼夜节律受到基础疾病的影响，并表明夜间血压水平升高可能有助于高血压合并 DN 患者尿蛋白排泄的增加。
The purpose of this study was to examine a possible difference in the 24-h blood pressure (BP) profile between hypertensives with diabetic nephropathy (DN) and those with non-diabetic glomerulopathy (non-DN). We measured 24-h ambulatory BP in 34 type 2 DN and 34 non-DN patients who were hospitalized for the educational program in our hospital. There were no significant differences in 24-h and daytime systolic BP between DN (143 vs. 136 mmHg, NS for 24-h systolic BP) and non-DN (143 vs. 138 mmHg, NS for daytime systolic BP). Although both groups disclosed blunted nocturnal decrease in BP and were classified as "non-dipper" type, DN patients had a significantly higher nighttime systolic BP than patients with non-DN (142 vs. 132 mmHg, p = 0.0217). BP and heart rate (HR) variabilities were also estimated, and patients with DN showed a reduced nighttime HR variability than those with non-DN (4.8 vs. 6.6 beats/min, p = 0.0115). DN patients had an increase in urinary protein excretion (3.0 vs. 1.4 g/day, p = 0.0095) and a decrease in serum albumin concentration (3.1 vs. 3.7 mg/dl, p < 0.0001). Furthermore, urinary protein excretion was significantly correlated with nighttime systolic BP (r = 0.480, p = 0.0031) but not with nighttime HR variability. Taken together, these results demonstrate that the circadian rhythms of BP and HR are affected by underlying diseases and suggest that an elevated nighttime BP level may contribute to the enhanced urinary protein excretion in hypertensives with DN.