The Relationship between Microalbuminuria and24h-ABPM in Hypertension Patients
|School||Dalian Medical University|
|Keywords||24h-ambulatory blood pressure (24h-ABPM) Urinary micro albumin creatinine ratio(UACR) Left ventricular mass index（LVMI） Pulse wave velocity（PWV）|
Backgroud and purpose: Hypertension can seriously affect the structure andfunction of heart, brain, kidney and other vital organs. It is considered as an independentrisk factor for cardiovascular diseases. Compare to official blood pressure,24h-ABPMcan reflect the acute level of blood pressure and correlate to the target organ damage.Microalbuminuria is the marker of the early damage of kindey.UACR can not onlyaffect the early kidney damage in hypertention, but also predict the incident of heart andother target organs. The purpose of this study is to discuss the relationship between24h-ABPM and UACR, and the effect of circadian change on damage of target organ. Itcan provide the theory to prevent and treat the target organ damage early for thehypertension patients.Methods:143patients who were in cardiovascular ward in the First Affiliated Hospital of Dalian Medical University from Sep2010to Dec2011with essential hypertension were enrolled in our study. Hypertension is diagnosed by the2005guidelines of Prevention and Treatment of Hypertension China. We notedthe patients’ blood pressure variance and also diurnal variation by using the24H-automaticambulatory blood pressure monitoring system. According to the circadian variation, the patients were divided into two groups, dipper group (descent rateof night blood pressure≥10%) and non-dipper group(descent rate of night bloodpressure＜10%).We recorded the patients’ history, biochemical investigations andpatients’ particular. At the same time, we did the echocardiogram to every patient and then calculated the Left Ventricular Mass Index (LVMI) by using Devereux method; also evaluated the arterial stiffness with Pulse wave velocity (PWV).All of the data were analyzed by SPSS13.5software.The statistical comparisons between dipper group and non-dipper group were analyzed by T-test. And the correlation between the parameter of ABPM and UACR were assessed by simple linear correlation. The relation between UACR and other risk factors were analyzed by using the multiple linear regression. The value of P <0.05was regardedas statistically significant.Results:1.There has the correlation between24h-DBP,24h-SBP，n-SBP, n-DBP,n-PP and UACR, but there is no correlation between office blood pressure and UACR.Both n-SBP and LVMI are independently related to UACR.2.Dipper group and non-dipper group have the statistical significant between the UACRand LVMI, but no difference with PWV.Conclusion:1. There is significant correlation between24H-ABPM and UACR,among them the n-SBP is the most significant. Both n-SBP and LVMI areindependently related to UACR. So that24H-ABPM is better than office BPmeasurement in estimating the target organ damage, in which n-SBP has therepresenting role.2.The UACR and LVMI of non-dipper group are higher than those of dipper group.Therefore, the abnormal circadian rhythm of BP will increase the risk of target organdamage.