标题：
Association of isolated morning hypertension with arterial measures in Untreated Chinese Patients
讲者：
郭芊卉
单位：
上海市高血压研究所
播放：
2426
论文摘要：
Objective: Morning hypertension was suggested to be closely associated with target organ damage and cardiovascular events. However, the independent contribution of morning hypertension to cardiovascular damage remains controversial. The purpose of our study was to investigate the association of isolated morning hypertension with measures of arterial stiffness and microalbuminuria in an untreated outpatient cohort.
Design and Method: We recruited consecutive outpatients who was suspected of having hypertension but not taking antihypertensive drugs for at least 2 weeks and referred to our hypertension clinic from November 2010 to June 2015. Home BP was self-measured with the Omron 7051 monitors for 7 days. Hypertension was defined as a mean home BP ≥135/85 mmHg either in the morning or in the evening. We assessed carotid-femoral pulse wave velocity (cfPWV) and central augmentation index (cAIx) with the SphygmoCor system as measures of arterial stiffness, and the morning urinary albumin/creatinine ratio (ACR) as measures of microalbuminuria.
Results: In the 1537 untreated outpatients (mean age, 51.0 years; women, 51.9%), 200 (13.0%) had isolated morning hypertension. Patients with isolated morning hypertension compared to normotensive subjects had faster cfPWV (8.1 vs 7.5 cm/s, P<0.001), increased urinary ACR (0.76 vs 0.65 mg/mmol, P=0.049), but similar cAIx (26.7 vs 25.3%, P=0.14). After adjustment for age, sex, body height and weight, heart rate, current smoking and alcohol intake, serum total cholesterol and fasting glucose, and evening systolic BP, the between-group difference in cfPWV (8.1 vs 7.8 cm/s, P=0.003) and cAIx (26.2 vs 24.5%, P=0.005) were statistically significant. In continuous analysis with aforementioned multivariate adjustment, home morning systolic BP was significantly (P≤0.007) associated with cfPWV and cAIx in men and cfPWV and urinary ACR in women.
Conclusions: Isolated morning hypertension is associated with arterial stiffness and increased wave reflections in untreated Chinese patients. Home morning BP was independently associated with arterial damage.
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