Relationship between Blood Pressure of Different Body Position and Renal Function in Hypertensive Patients

Objective:To explore the difference of blood pressure in hypertensive patients with standing, sitting, lying postures and to explore correlation between blood pressure in three postures mentioned above and changes in blood pressure caused by postural change with renal function-related parameters. Methods: We recruited242(154male,88female) patients hospitalized in hypertension diagnosis and therapy center in hospital of Xin-jiang uygur autonomous region to administrate postural experiment. Subjects were required not to take any antihypertensive drugs the night before the experiment, we measured blood pressure of participants with standing, sitting,and lying positions that were maintained for two hours respectively under normalsituation. During the measurement, we used arm type dynamic blood pressure monitoring to record electronic blood pressure value, and we determined serum creatinine (Cr),uric acid(UA),24hour urinary protein etal, and estimated GFR using MDRD. Then we analyzed whether there were differences in blood pressure levels of three different body positions and correlations between blood pressure and renal function-related parameters. Results: Systolic and diastolic blood pressure in three different body positions decrease with changing of body poses respectively:standing posture>sitting posture>lying posture(P<0.05).Blood pressures of three postures are notboth correlated with age、β=BMI(P>0.05). Differences of urine occult blood; Urinary erythrocyte in hypertensive patients with different body posture are statistically significant(P<0.05)；stanging posture is the highest.After adjusting gender、age、medical history and BMI，multivarience linear regression mode showed made showed24hour urinary protein is correlated with systolic blood pressure of three body posture （β=0.213，β=0.270、β=0.189，P<0.01）；UA is correlated with systolic bloodpressure of standing and lying、TG（β=0.139，β=0.242，β=0.387，P<0.05）;GFR is positively correlated with gender,and negatively correlated with age、BUN and sta nding and lying posture diastolic blood pressure.Conclusion: Changes in blood pressure caused by postural changedo little harm to renalfunction. Systolic blood pressure in three different body postures are the risk factoof24hour urinary protein; systolic blood pressure in standing posture and lying posture are the risk factor of UA; diastolic blood pressure in standing posture and lying posture are the risk factorof GFR.