ABSTRACT

Objective

Masked hypertension (MH) and non-dipping pattern are conditions associated with target organ damage and cardiovascular risk, which are frequently observed together. We aimed to show the relationship between the target organ damage observed in MH and the deterioration in the dipping pattern.

Methods

Patients who underwent ambulatory blood pressure monitoring (ABPM) and office blood pressure (BP) <140/90 mmHg were retrospectively screened. In ABPM data, those with daytime BP ≥135/85 mmHg and night BP ≥120/70 mmHg were included in the MH group, while the others were included in the normotensive group. The patients were grouped as dipper, non-dipper and reverse-dipper according to ABPM results. Left ventricular mass index (LVMI), glomerular filtration rate (GFR) and serum creatinine levels were used to determine target organ damage.

Results

289 patients [mean age 46.6 ± 12.4 years, 136 (47.1%) males], 154 (53.3%) of whom had MH were included in our study. GFR value was found to be significantly lower, serum creatinine levels and LVMI were significantly higher in patients with MH compared to normotensives (p < .05, for all). When the subgroups were examined, it was found that this difference was associated with the disruption in the dipping pattern. In patients with MH, dipping pattern disruption without change in systolic BP was independently associated with an increase in LVMI (p < .05, for both).

Conclusion

Target organ damage seen in MH may be due to the deterioration of the dipping pattern.

中文翻译：

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隐匿性高血压的靶器官损害是由哪一个原因造成的？是血压升高还是昼夜节律紊乱？

摘要

客观的

隐匿性高血压 (MH) 和非浸渍模式是与靶器官损伤和心血管风险相关的疾病，经常一起观察到这些疾病。我们旨在显示在 MH 中观察到的靶器官损伤与浸渍模式恶化之间的关系。

方法

回顾性筛选接受动态血压监测（ABPM）和诊室血压（BP）<140/90 mmHg的患者。ABPM数据中，日间BP≥135/85 mmHg和夜间BP≥120/70 mmHg的患者被纳入MH组，其余患者均被纳入正常血压组。根据ABPM结果将患者分为杓型、非杓型和反向杓型。左心室质量指数（LVMI）、肾小球滤过率（GFR）和血清肌酐水平用于确定靶器官损伤。

结果

我们的研究包括 289 名患者 [平均年龄 46.6 ± 12.4 岁，136 名（47.1%）男性]，其中 154 名（53.3%）患有 MH。与血压正常的患者相比，MH 患者的 GFR 值显着降低，血清肌酐水平和 LVMI 显着升高（p < .05）。当检查亚组时，发现这种差异与浸渍模式的破坏有关。在 MH 患者中，收缩压无变化的浸渍模式中断与 LVMI 增加独立相关（两者均p < .05）。

结论

在 MH 中看到的靶器官损伤可能是由于浸渍模式的恶化。