Association of circadian blood pressure pattern and left heart chamber enlargement in hypertensive patients:A cross-sectional study  

作　　者：ZHONG Qi CAI An-ping LIU Chao-fan ZHOU Dan LI Xi-da FENG Ying-qing ZHOU Ying-ling 钟琪;蔡安平;刘超凡;周丹;李希大;冯颖青;周颖玲(Department of Cardiology,Guangdong Cardiovascular Institute,Guangdong Provincial Key Laboratory of Coronary Disease,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China)

机构地区：[1]Department of Cardiology,Guangdong Cardiovascular Institute,Guangdong Provincial Key Laboratory of Coronary Disease,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China

出　　处：《South China Journal of Cardiology》2020年第4期227-234,共8页岭南心血管病杂志（英文版）

基　　金：supported by the Key Area R&D Program of Guangdong Province(No.2019B020227005);National Key Research and Development Program of China(No.2016YFC1301202)。

摘　　要：Background Non-dipping blood pressure(BP)pattern is a potential risk factor contributing to cardiac geometry change.Relationship between BP pattern and left atrium(LA)enlargement besides left ventricle(LV)structural change is seldom studied.Methods A total of 237 hypertensive and hospitalized adults were enrolled.Left heart chamber parameters were measured by 2-dimensional echocardiography,and BP circadian rhythm was evaluated by 24-hour ambulatory blood pressure monitoring.Night-day ratios of systolic BP(NDR-SBP)were calculated and BP patterns were classified into dippers,reduced-dippers,and risers,which were defined as NDR-SBP<0.9,≥0.9 and<1,≥1,respectively.Multiple logistic regression analyses were performed to identify the factors associated with increased left ventricular end-diastolic internal diameter and left atrial diameter.Results Among enrolled participants,there were 62(26.2%)dippers,136(57.4%)reduced-dippers and 39(16.5%)risers.Briefly,57.8%were male and the mean age was 57.0±13.9 years.Compared to the dippers,both left ventricular end-diastolic diameter(44.4±4.3 mm in dippers,45.5±4.0 mm in reduced-dippers,46.5±4.5 mm in risers,P=0.045)and left atrial diameter(32.7±4.1 mm in dippers,34.3±4.7 mm in reduced-dippers,35.7±4.3 mm in risers,P=0.004)were progressively increased in reduced-dippers and risers.Logistic regression analyses showed that after adjusted for age,male gender,history of diabetes,blood lipid profiles,mean diurnal BP and estimated glomerular filtration rate,the association between increased LV diameter and riser BP pattern was significant(OR:2.621,95%CI:1.030-6.678)while the association between increased LA diameter and riser BP pattern was marginally significant.Conclusions The riser BP pattern is associated with the enlargement of LV and probably that of LA in hypertensive patients independent of 24-hour systolic BP level.

关 键 词：ambulatory blood pressure monitoring ventricular remodeling hypertension circadian rhythm 

分 类 号：R544.1[医药卫生—心血管疾病]