{"title":"低、中度心血管危险治疗患者隐匿性夜间高血压发展的预测因素","authors":"A. Chernyavina, N. M. Syuzeva","doi":"10.18705/1607-419x-2022-28-4-376-385","DOIUrl":null,"url":null,"abstract":"Objective. To determine the predictors of the development of masked nocturnal hypertension (HTN) in treated patients of low and moderate cardiovascular risk (CVR). Design and methods. The study included 94 patients with treated HTN of low and moderate CVR without verified cardiovascular diseases. The median age was 42,24 ± 8,08 years. Patients were examined in accordance with the Clinical guidelines on HTN of the Russian Society of Cardiology, approved by the Ministry of Health of the Russian Federation (2020). Patients were divided into two groups depending on the presence or absence of masked nocturnal hypertension. The first group consisted of 54 (57,4 %) patients with masked nocturnal hypertension, the second group — 40 (42,6 %) patients with HTN and target indicators of office blood pressure (BP) and BP according to 24-hour BP monitoring. Results. A direct strong correlation between systolic BP at night and uric acid levels (r = 0,62, p < 0,001), a direct moderate relationship with the cardio-ankle-vascular index (CAVI1) (r = 0,31, p = 0,002), and an inverse moderate relationship with the concentration of high-density lipoprotein cholesterol (HDL cholesterol) (r = -0,47, p < 0,001) were found. When conducting logistic regression analysis and constructing a ROC-curve, the following predictors of the development of masked nocturnal HTN were established: an increase in uric acid > 389 μmol/l, a decrease in HDL < 1,49 mmol/l, an increase in the CAVI1 index > 6,9. Conclusions. In effectively treated patients with HTN with moderate and low CVR, the development of masked nocturnal HTN is associated with an increase in uric acid levels > 389 μmol/l, regardless of sex, an increase in the CAVI1 index > 6,9 and a decrease in HDL cholesterol levels < 1,49 mmol/l.","PeriodicalId":37695,"journal":{"name":"Arterial Hypertension (Russian Federation)","volume":"83 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictors of the development of masked nocturnal hypertension in treated patients of low and moderate cardiovascular risk\",\"authors\":\"A. Chernyavina, N. M. Syuzeva\",\"doi\":\"10.18705/1607-419x-2022-28-4-376-385\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective. To determine the predictors of the development of masked nocturnal hypertension (HTN) in treated patients of low and moderate cardiovascular risk (CVR). Design and methods. The study included 94 patients with treated HTN of low and moderate CVR without verified cardiovascular diseases. The median age was 42,24 ± 8,08 years. Patients were examined in accordance with the Clinical guidelines on HTN of the Russian Society of Cardiology, approved by the Ministry of Health of the Russian Federation (2020). Patients were divided into two groups depending on the presence or absence of masked nocturnal hypertension. The first group consisted of 54 (57,4 %) patients with masked nocturnal hypertension, the second group — 40 (42,6 %) patients with HTN and target indicators of office blood pressure (BP) and BP according to 24-hour BP monitoring. Results. A direct strong correlation between systolic BP at night and uric acid levels (r = 0,62, p < 0,001), a direct moderate relationship with the cardio-ankle-vascular index (CAVI1) (r = 0,31, p = 0,002), and an inverse moderate relationship with the concentration of high-density lipoprotein cholesterol (HDL cholesterol) (r = -0,47, p < 0,001) were found. When conducting logistic regression analysis and constructing a ROC-curve, the following predictors of the development of masked nocturnal HTN were established: an increase in uric acid > 389 μmol/l, a decrease in HDL < 1,49 mmol/l, an increase in the CAVI1 index > 6,9. Conclusions. In effectively treated patients with HTN with moderate and low CVR, the development of masked nocturnal HTN is associated with an increase in uric acid levels > 389 μmol/l, regardless of sex, an increase in the CAVI1 index > 6,9 and a decrease in HDL cholesterol levels < 1,49 mmol/l.\",\"PeriodicalId\":37695,\"journal\":{\"name\":\"Arterial Hypertension (Russian Federation)\",\"volume\":\"83 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-07-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arterial Hypertension (Russian Federation)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18705/1607-419x-2022-28-4-376-385\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arterial Hypertension (Russian Federation)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18705/1607-419x-2022-28-4-376-385","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目标。目的探讨低、中度心血管危险(CVR)患者隐匿性夜间高血压(HTN)发生的预测因素。设计和方法。本研究纳入94例经治疗的中低CVR HTN患者,无心血管疾病。中位年龄为42,24±8.08岁。根据俄罗斯联邦卫生部批准的《俄罗斯心脏病学会HTN临床指南》(2020年)对患者进行检查。根据隐匿性夜间高血压的存在与否将患者分为两组。第一组为隐匿性夜间高血压患者54例(57,4%),第二组为HTN患者40例(42,6%),根据24小时血压监测以办公室血压(BP)和血压为目标指标。结果。研究发现,夜间收缩压与尿酸水平呈正相关(r = 0,62, p < 0.001),与心踝血管指数(CAVI1)呈正相关(r = 0,31, p = 0,002),与高密度脂蛋白胆固醇(HDL)浓度呈负相关(r = -0,47, p < 0.001)。通过logistic回归分析和roc曲线构建,建立了隐匿性夜间HTN发生的预测因子:尿酸升高> 389 μmol/l, HDL降低< 1,49 mmol/l, CAVI1指数升高> 6,9。结论。在有效治疗的中低CVR HTN患者中,隐匿性夜间HTN的发生与尿酸水平升高> 389 μmol/l(不分性别)、CAVI1指数升高> 6,9和HDL胆固醇水平降低< 1,49 mmol/l相关。
Predictors of the development of masked nocturnal hypertension in treated patients of low and moderate cardiovascular risk
Objective. To determine the predictors of the development of masked nocturnal hypertension (HTN) in treated patients of low and moderate cardiovascular risk (CVR). Design and methods. The study included 94 patients with treated HTN of low and moderate CVR without verified cardiovascular diseases. The median age was 42,24 ± 8,08 years. Patients were examined in accordance with the Clinical guidelines on HTN of the Russian Society of Cardiology, approved by the Ministry of Health of the Russian Federation (2020). Patients were divided into two groups depending on the presence or absence of masked nocturnal hypertension. The first group consisted of 54 (57,4 %) patients with masked nocturnal hypertension, the second group — 40 (42,6 %) patients with HTN and target indicators of office blood pressure (BP) and BP according to 24-hour BP monitoring. Results. A direct strong correlation between systolic BP at night and uric acid levels (r = 0,62, p < 0,001), a direct moderate relationship with the cardio-ankle-vascular index (CAVI1) (r = 0,31, p = 0,002), and an inverse moderate relationship with the concentration of high-density lipoprotein cholesterol (HDL cholesterol) (r = -0,47, p < 0,001) were found. When conducting logistic regression analysis and constructing a ROC-curve, the following predictors of the development of masked nocturnal HTN were established: an increase in uric acid > 389 μmol/l, a decrease in HDL < 1,49 mmol/l, an increase in the CAVI1 index > 6,9. Conclusions. In effectively treated patients with HTN with moderate and low CVR, the development of masked nocturnal HTN is associated with an increase in uric acid levels > 389 μmol/l, regardless of sex, an increase in the CAVI1 index > 6,9 and a decrease in HDL cholesterol levels < 1,49 mmol/l.
期刊介绍:
The main aims of the Journal include collecting and generalizing the knowledge in hypertensiology; education and professional development of cardiologists and medical doctors of other specialties, who deal with different issues regarding diagnostics, management and prevention of hypertension in both clinical practice and research. The Journal also calls attention to the most urgent and up-to-date questions in hypertensiology, cardiology and related sciences. There are additional objectives, such as increasing the availability, accessibility and recognition of Russian medical scientific achievements at the international level by improving the quality of the publication and the way they are presented; enabling the exchange of opinions and information between scientists and their wider communication. The main criteria for publication selection fit with the mentioned objectives and include currency, singularity, scientific and practical novelty, applied relevance etc.