Diurnal Blood Pressure Rhythmicity in Relation to Environmental and Genetic Cues in Untreated Referred Patients
Diurnal Blood Pressure Rhythmicity in Relation to Environmental and Genetic Cues in Untreated Referred Patients
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未经治疗的转诊患者的昼夜血压节律与环境和遗传线索相关。
DOI：
10.1161/hypertensionaha.116.07958
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发表时间：
2017-01-01
期刊：
影响因子：
8.3
通讯作者：
Li, Yan
中科院分区：
文献类型：
--
作者：
Sheng, Chang-Sheng;Cheng, Yi-Bang;Li, Yan
没有以前的研究已经解决了环境和遗传线索的昼夜血压节律性的相对贡献。从未经治疗的患者（51%为女性，平均年龄51岁）的24小时动态收缩压记录中，我们计算了897例患者的夜间与白天的比值和637例患者的晨峰。环境线索包括季节、室外日平均温度、气压、湿度和工作日，遗传线索包括10个时钟基因中的14个单核苷酸多态性。收缩压平均值（±SD）为126.7±11.9 mm Hg，昼夜比值为0.86±0.07，晨峰为24.8±10.7 mm Hg。在校正分析中，与年平均值相比，夏季的夜-日比率高2.4%，冬季低1.8%（P<0.001），温度的影响较小（P=0.079）;夏季的晨潮低1.7 mm Hg，冬季高1.1 mm Hg（P<0.001）。其他环境因素并没有增加昼夜比或晨峰方差（P≥0.37）。在14个遗传变异中，只有时钟rs 180260与季节，温度和其他宿主因素调整后和Bonferroni校正后的晨峰显著相关（P=0.044）。在CLOCK rs 1801260 C等位基因携带者（n=83）中，晨峰比TT纯合子（n=554）高3.7 mm Hg。在昼夜比和晨峰方差中，季节和温度分别解释了0.8%和0.3%，而对于遗传线索，这些比例为0.1%或更少。总之，与遗传线索相比，环境因素是血压昼夜节律性的更强驱动力。
No previous study has addressed the relative contributions of environmental and genetic cues to the diurnal blood pressure rhythmicity. From 24-hour ambulatory recordings of systolic blood pressure obtained in untreated patients (51% women; mean age, 51 years), we computed the night-to-day ratio in 897 and morning surge in 637. Environmental cues included season, mean daily outdoor temperature, atmospheric pressure, humidity and weekday, and the genetic cues 14 single nucleotide polymorphisms in 10 clock genes. Systolic blood pressure averaged (±SD) 126.7±11.9 mm Hg, night-to-day ratio 0.86±0.07, and morning surge 24.8±10.7 mm Hg. In adjusted analyses, night-to-day ratio was 2.4% higher in summer and 1.8% lower in winter (P<0.001) compared with the annual average with a small effect of temperature (P=0.079); morning surge was 1.7 mm Hg lower in summer and 1.1 mm Hg higher in winter (P<0.001). The other environmental cues did not add to the night-to-day ratio or morning surge variance (P≥0.37). Among the 14 genetic variations, only CLOCK rs180260 was significantly associated with morning surge after adjustment for season, temperature, and other host factors and after Bonferroni correction (P=0.044). In CLOCK rs1801260 C allele carriers (n=83), morning surge was 3.7 mm Hg higher than in TT homozygotes (n=554). Of the night-to-day ratio and morning surge variance, season and temperature explained ≈8% and ≈3%, while for genetic cues, these proportions were ≈1% or less. In conclusion, environmental compared with genetic cues are substantially stronger drivers of the diurnal blood pressure rhythmicity.