原发性高血压患者的血压变异性与血尿酸水平的相关性研究

Correlation between blood pressure variability and serum uric acid levels in patients with essential hypertension

目的 探讨新发原发性高血压患者血压变异性和血尿酸水平的关联性。方法 纳入2019年9月至2021年12月因首次确诊为原发性高血压在宣城市人民医院心血管内科住院的患者385例,并完善动态血压监测。根据三分位方法将纳入患者分为低血尿酸组(≤305 mmol/L)128例,中血尿酸组(305~386 mmol/L)130例,高血尿酸组(>386 mmol/L)127例。基于多变量回归分析新发的原发性高血压患者中血尿酸水平与收缩压变异系数以及舒张压变异系数的关系。结果 与低血尿酸组比较,中、高尿酸组患者的白天收缩压血压负荷、白天收缩压平均值、24 h收缩压标准差、24 h舒张压标准差、24 h收缩压变异系数和24 h舒张压变异系数更高(P<0.05)。多因素回归分析显示,年龄、糖尿病、中高血尿酸分组是24 h收缩压变异系数独立的影响因素(P<0.05)。年龄及中、高血尿酸分组是24 h舒张压变异系数独立的影响因素(P<0.05)。结论 在新发原发性高血压患者中,血尿酸是24 h收缩压变异系数及24 h舒张压变异系数的影响因素。

Objective To investigate the correlation between serum uric acid level and blood pressure variability in patients with new-onsetessential hypertension.Methods Three hundred and eighty-five patients with new-onset essential hypertension from September 2019 to December 2021 in Xuancheng People′s Hospital were selected. All patients received detection of ambulatory blood pressure and 24 hours dynamic electrocardiogram. According to the tertile method, the patients were divided into ahypoglycemic acid group(≤305 mmol/L, n= 128), a moderate blood uric acid group(305~386 mmol/L, n= 130), and a hyperuricemia group(>386 mmol/L, n= 127).Multivariate regression analysis was used to analyze the potential associations between serum uric acid levels and coefficients of variation of systolic and diastolic blood pressure in these patients.Results The daytime systolic blood pressure load, mean of daytime systolic blood pressure, 24 hour systolic blood pressure standard deviation, 24 hour diastolic blood pressure standard deviation, 24 hour systolic blood pressure variability and 24 hour diastolic blood pressure variability in the moderate blood uric acid group and the hyperuricemia group were higher than those in the hypoglycemic acid group(P<0.05). Multiple linear regression analysis showed that age, diabetes, and middle and high uric acid were the influencing factors of 24 h systolic pressure standard deviation. The analysis also showed that age and middle and high uric acid were the influencing factors of 24 h diatonic pressure standard deviation.Conclusions The serum level of uric acid is an influencing factor for 24 hour systolic or diastolic blood pressure variability in patients with new-onset essential hypertension.