Circadian Blood Pressure Profile and Associated Cardiovascular Risk Factors in Prehypertensive Patients and Its Relationship with Urinary Albumin-to-Creatinine Ratio.

Q3 Medicine
Jaldu Krishna Pavan, Ashok Kumar, Gutti Prasanth, Shubha Laxmi Margekar, Shivani Bansal
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Abstract

Background: Prehypertension is characterized by a systolic blood pressure (SBP) ranging from 120 to 139 mm Hg and a diastolic blood pressure (DBP) between 80 and 89 mm Hg, acting as a precursor to hypertension and potentially increasing cardiovascular risks. This study investigates the circadian patterns of blood pressure (BP), dipper status, and associated cardiovascular risk factors in prehypertensive individuals, with a particular focus on the relationship with the urinary albumin-to-creatinine ratio (UACR) as a marker of kidney and vascular health.

Objective: To assess the circadian rhythm of BP in prehypertensive patients and examine its relationship with UACR and other cardiovascular risk factors.

Methods: In this research involving systematic observation, a total of 101 participants were included, 57.4% of whom were identified as prehypertensive. Prehypertensive participants were grouped into "dippers" or "nondippers" based on a nocturnal BP reduction threshold of greater than or <10%, respectively. UACR, high-sensitivity C-reactive protein (Hs-CRP), lipid profiles, and additional biochemical parameters were measured. Statistical analysis included t-tests and analysis of variance (ANOVA) were utilized to examine associations.

Results: Prehypertensive subjects demonstrated significantly higher mean 24-hour SBP and DBP than normotensive controls (p < 0.001). Dipper status was identified in 55.2% of prehypertensives, with nondippers exhibiting elevated nighttime SBP and DBP (p < 0.001). UACR and nondipper status were found to be significantly correlated (p = 0.034), with nondippers also displaying elevated Hs-CRP levels, indicating greater systemic inflammation.

Conclusion: Circadian BP variability and dipper status in prehypertensive patients correlate with UACR and Hs-CRP levels, suggesting that nondippers may be at increased cardiovascular risk. Ambulatory blood pressure monitoring (ABPM) offers valuable insights into early hypertension risk and can aid in identifying prehypertensive individuals requiring closer monitoring and intervention.

高血压前期患者昼夜血压、相关心血管危险因素及其与尿白蛋白/肌酐比值的关系
背景:高血压前期的特点是收缩压(SBP)在120 - 139毫米汞柱之间,舒张压(DBP)在80 - 89毫米汞柱之间,这是高血压的前兆,可能会增加心血管风险。本研究调查了高血压前期个体的血压(BP)的昼夜节律模式、尿床状态和相关心血管危险因素,特别关注尿白蛋白与肌酐比(UACR)作为肾脏和血管健康的标志的关系。目的:评价高血压前期患者血压昼夜节律,探讨其与UACR及其他心血管危险因素的关系。方法:采用系统观察的方法,共纳入101例受试者,其中57.4%为高血压前期。根据夜间血压降低阈值大于或t检验和方差分析(ANOVA)来检验相关性,将高血压前期参与者分为“降压者”和“非降压者”。结果:高血压前期受试者的平均24小时收缩压和舒张压明显高于正常对照组(p < 0.001)。55.2%的高血压前期患者有尿床状态,未尿床的患者夜间收缩压和舒张压升高(p < 0.001)。UACR与未浸液状态显著相关(p = 0.034),未浸液状态也显示Hs-CRP水平升高,表明更大的全身性炎症。结论:高血压前期患者的昼夜血压变异性和尿床状态与UACR和Hs-CRP水平相关,提示不尿床可能增加心血管风险。动态血压监测(ABPM)为早期高血压风险提供了有价值的见解,并有助于识别需要更密切监测和干预的高血压前期个体。
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