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外文期刊>BMC Nephrology
>Ambulatory blood pressure is better associated with target organ damage than clinic blood pressure in patients with primary glomerular disease
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Ambulatory blood pressure is better associated with target organ damage than clinic blood pressure in patients with primary glomerular disease
Blood pressure is an important and modifiable cardiovascular risk factor. Ambulatory blood pressure monitoring (ABPM) provides valuable prognostic information in patients with chronic kidney disease (CKD), yet little is known about the association of various types of BP measurements with target organ damage (TOD) in patients with primary glomerular disease. The goal of this study was to investigate whether ambulatory blood pressure is better associated with TOD than clinic blood pressure in patients with primary glomerular disease. 1178 patients with primary glomerular disease were recruited in this cross-sectional study. TOD were assessed by the following 4 parameters: left ventricular mass index (LVMI or LVH, left ventricular hypertrophy), estimated glomerular filtration rate (eGFR?60?ml/min/1.73m2), albumin-to-creatinine ratio (ACR?≥?30?mg/g) and carotid intima-media thickness (cIMT) or plaque. Receiver operating characteristic (ROC) curve and multivariate logistic regression analyses were used to evaluate the relationship between ambulatory or clinic systolic blood pressure (SBP) indexes and TOD. Among 1178 patients (mean age, 39?years,54% men), 116, 458, 1031 and 251 patients had LVH, eGFR ?60?ml/min/1.73m2, ACR?≥?30?mg/g and cIMT≥0.9?mm or plaque respectively. Area under ROC curves for TOD in ambulatory SBP, especially nighttime SBP, was greater than that in clinic SBP (P??0.05). Multivariate logistic regression analyses showed that 24?h SBP, daytime SBP and nighttime SBP were significantly associated with LVH, eGFR?60?ml/min/1.73m2 and ACR?≥?30?mg/g after adjustment for clinic SBP, while the association of clinic SBP was attenuated after further adjustment for nighttime SBP. Ambulatory blood pressure, especially nighttime blood pressure, is probably superior to clinic blood pressure and has a significant association with TOD in primary glomerular disease patients.
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机译：血压是一个重要而可修正的心血管危险因素。动态血压监测（ABPM）为慢性肾病（CKD）的患者提供了有价值的预后信息，但对于初级肾小球疾病患者的靶器官损伤（TOD），各种类型的BP测量与靶器官损伤（TOD）的关联知之甚少。本研究的目标是调查对原发性肾小球疾病患者的临床血压比如何与TOD相关的动态血压。在该横断面研究中招募了1178例初级肾小球疾病患者。通过以下4个参数评估TOD：左心室质量指数（LVMI或LVH，左心室肥大），估计肾小球过滤速率（EGFR <β60？mL / min / 1.73m2），白蛋白 - 致肌酐比率（ACR？ ≥？30？mg / g）和颈动脉内膜厚度（CIMT）或斑块。接收器操作特征（ROC）曲线和多变量逻辑回归分析用于评估动态或临床收缩压（SBP）指标和TOD之间的关系。在1178名患者中（平均年龄，39岁，54％，54％），116,458,1031和251名患者有LVH，EGFR <？60？ML / min / 1.73m2，ACR？≥？30？MG / G和CIMT ≥0.9？mm或斑块。在AMPulatory SBP中的ROC曲线下的区域，尤其是夜间SBP，大于临床SBP（P？<？0.05）。多变量逻辑回归分析显示，24？H SBP，白天SBP和夜间SBP与LVH，EGFR <60？ml / mil / min / 1.73m2和ACR？≥？30？Mg / g进行调整后，诊所SBP，而且在进一步调整夜间SBP后，临床SBP的关联被衰减。动态血压，尤其是夜间血压，可能优于临床血压，并在原发性肾小球病患者中具有重要关联。
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