ABSTRACT

Background: We aimed to investigate the association between morning surge (MS) of blood pressure (BP) and SYNTAX score (SS) which gives information regarding the complexity and extent of coronary artery disease (CAD) in hypertensive patients. 

Methods: We included 187 hypertensive patients (134 males, 53 females; mean age: 62.5 ± 10.9 years) who underwent elective coronary angiography. Patients with the acute coronary syndrome and a history of coronary intervention were excluded from the study. The MBPS was calculated as the difference between the average BP during the 2 hours after awakening (four BP readings) and the lowest nighttime BP. The severity of coronary lesions was evaluated based on the SS assessed by coronary angiography. Patients were classified into two groups according to SS: low SS (SS ≤ 22) and intermediate-to-high SS (>22).

Results: Patients in the intermediate-to-high SS group were found to be older, have higher uric acid levels, average daytime systolic BP (SBP), nighttime SBP, morning SBP, MS of BP and have higher rates of diabetes (DM) and female gender. There was no significant difference in terms of hypertensive treatment. In multivariate analysis, MS of BP (OR: 2.151, p: 0.005) and DM (OR: 0.014, p: 0.015) were independent parameters for predicting intermediate-to-high SS. The cutoff value of MS of BP obtained by ROC curve analysis was 18,5 mmHg for prediction of intermediate–high SS (sensitivity: 76.5%, specificity: 71.2%). The area under the curve was 0.762 (p < .001).

Conclusion: MS of BP significantly correlates with the severity of coronary stenosis in hypertensive patients, suggesting that it could be a potential predictive marker of CAD.

摘要

背景：我们的目的是调查血压早上血压（MS）与SYNTAX评分（SS）之间的关联，该关联可提供有关高血压患者冠状动脉疾病（CAD）的复杂性和程度的信息。 

方法：我们纳入了187例行择期冠状动脉造影的高血压患者（男134例，女53例；平均年龄：62.5±10.9岁）。该研究排除了患有急性冠状动脉综合征和有冠状动脉介入治疗史的患者。MBPS计算为唤醒后2小时内的平均BP（四个BP读数）与最低的夜间BP之差。冠状动脉病变的严重程度是根据通过冠状动脉造影评估的SS进行评估的。根据SS将患者分为两组：低SS（SS≤22）和中高SS（> 22）。

结果：中高SS组患者年龄较大，尿酸水平较高，白天平均收缩压（SBP），夜间SBP，早晨SBP，BP MS，糖尿病（DM）较高。和女性。在高血压治疗方面没有显着差异。在多变量分析中，BP的MS（OR：2.151，p：0.005）和DM（OR：0.014，p：0.015）是预测中高SS的独立参数。通过ROC曲线分析获得的BP的MS截止值为18,5 mmHg，可预测中高SS（敏感性：76.5％，特异性：71.2％）。曲线下的面积为0.762（p <.001）。

结论：血压的MS与高血压患者冠状动脉狭窄的严重程度密切相关，提示它可能是CAD的潜在预测指标。