Influence of nycthemeral blood pressure pattern in treated hypertensive patients on hemodialysis.
Influence of nycthemeral blood pressure pattern in treated hypertensive patients on hemodialysis.
复制标题
治疗高血压患者夜间血压模式对血液透析的影响。
作者：
Jacques Amar;Isabelle Vernier;E. Rossignol;V. Lenfant;Jean J. Conte;B. Chamontin
终末期肾病（ESRD）患者的动脉高血压的特征是血压（BP）节律改变和脉压增加，这可能表明，这种危险因素的关联在这一人群的心血管预后中起着重要作用。本研究的目的是确定在接受定期血液透析治疗的高血压患者中，夜间血压模式对动脉扩张性和血压脉动成分的影响。42名高血压患者被纳入研究，所有患者均接受了股动脉和颈动脉之间的动态血压和脉搏波速度（PWV）测量。根据夜间血压下降的幅度，将患者分为两组：杓型和非杓型。各组在性别、年龄、血液透析持续时间、体重指数、体型、心血管并发症史、每例患者使用的降压药物类别和数量方面相似。PWV在非杓型患者中显著较高。对于整个人群，逐步回归分析显示PWV和促红细胞生成素治疗与受损的夜间血压模式独立相关。促红细胞生成素除了具有升压作用外，还可能对接受治疗的ESRD高血压患者的动态血压曲线产生有害影响。动脉扩张性和夜间血压损害是相关的，在管理高血压血液透析患者时应综合考虑这些心血管危险因素。
Arterial hypertension in end-stage renal disease (ESRD) patients is characterized by an altered nycthemeral blood pressure (BP) rhythm and an increased pulse pressure, and it could be suggested that this association of risk factors plays a major role in the cardiovascular prognosis of this population. The aim of this study was to determine the influence of nycthemeral BP pattern on arterial distensibility and pulsatile components of BP in treated hypertensive patients on regular hemodialysis. Forty-two hypertensive patients were included, and all underwent ambulatory BP and pulse wave velocity (PWV) measurements between the femoral and carotid arteries. The patients were divided into two groups according to the magnitude of the nocturnal fall in BP: dippers and non-dippers. The groups were similar in gender, age, duration of hemodialysis, body mass index, body size, history of cardiovascular complications, class and number of antihypertensive drugs used per patient. PWV was significantly higher in non-dippers. For the whole population, a stepwise regression analysis showed that PWV and erythropoietin therapy were independently related to the impaired nycthemeral BP pattern. In addition to its pressor effect, erythropoietin could have a deleterious influence on the ambulatory BP profile of treated hypertensive patients in ESRD. Arterial distensibility and nycthemeral BP impairment are linked, and these cardiovascular risk factors should be taken into account together for the management of hypertensive hemodialysis patients.
影响因子：
158.5
作者：
CONVERSE, RL;JACOBSEN, TN;VICTOR, RG
通讯作者：
VICTOR, RG