PECULIARITIES OF AMBULATORY BLOOD PRESSURE MONITORING IN PATIENTS WITH ARTERIAL HYPERTENSION STAGES I - II WITH URIC ACID METABOLISM ABNORMALITIES
- Authors: Donskov AS1
-
Affiliations:
- Issue: No 4 (2009)
- Pages: 50-53
- Section: Articles
- URL: https://journals.eco-vector.com/2075-3594/article/view/245848
- ID: 245848
Cite item
Full Text
Abstract
Purpose. Characterization of daily rhythm of blood pressure in patients with arterial hypertension stages I-II with hyperuricosuria/hyperuricaemia.
Materials and methods. 24-hour BP monitoring was performed in 71 patients with arterial hypertension stages I-II not receiving ongoing antihypertensive therapy. In addition to conventional physical examination, all patients were examined for signs of metabolic syndrome, uricemia, and uricosuria.
Results. The insufficient nocturnal decrease of BP was detected in 26% of patients with hyperuricosuria/hyperuricaemia, in 23% - increase of BP in the night, and in 13% - excessive reduction BP level at night. The number of hypertensive patients with night-peacker type of diurnal curve was significantly greater in the group with hyperuricemia/hyperuricosuria compared with those who have no violations of uric acid metabolism (23 and 3% respectively, p <0.01).
Conclusion. Hyperuricemia/hyperuricosuria in arterial hypertension stages I-II predisposes to disorders of the diurnal curve of blood pressure, which characterized mainly by insufficient decrease or further increase of BP at night.
Materials and methods. 24-hour BP monitoring was performed in 71 patients with arterial hypertension stages I-II not receiving ongoing antihypertensive therapy. In addition to conventional physical examination, all patients were examined for signs of metabolic syndrome, uricemia, and uricosuria.
Results. The insufficient nocturnal decrease of BP was detected in 26% of patients with hyperuricosuria/hyperuricaemia, in 23% - increase of BP in the night, and in 13% - excessive reduction BP level at night. The number of hypertensive patients with night-peacker type of diurnal curve was significantly greater in the group with hyperuricemia/hyperuricosuria compared with those who have no violations of uric acid metabolism (23 and 3% respectively, p <0.01).
Conclusion. Hyperuricemia/hyperuricosuria in arterial hypertension stages I-II predisposes to disorders of the diurnal curve of blood pressure, which characterized mainly by insufficient decrease or further increase of BP at night.
References
- Staessen J., Thijs L., Fagard R., et al. for the Systolic Hypertension in Europe Trial Investigators. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. JAMA 1999;282:539-46.
- Okhubo T., Hozawa A., Yamaguchi J., et al. Prognostic significance of the nocturnal decline in blood pressure in subjects with and without high 24-hour blood pressure: the Ohasama study. J. Hypertens. 2002;20:2183-89.
- O'Brien E., Coats A., Owens P., et al. Use and interpretation of ambulatory blood pressure monitoring: recommendations of the British Hypertension Society. BMJ 2000;320:1128-34.
- Российское медицинское общество по артериальной гипертонии - Всероссийское научное общество кардиологов. Диагностика и лечение артериальной гипертензии. Российские рекомендации (3-й пересмотр.). М., 2008.
- Чазова И.Е., Мычка В.Б. Метаболический синдром. М., 2004.
- Felicio J.S., Pacheco J.T., Ferreira S.R., et al. Hyperglycemia and nocturnal systolic blood pressure are associated with left ventricular hypertrophy and diastolic dysfunction in hypertensive diabetic patients. Cardiovasc. Diabetol. 2006;5:19-26.
- Felício J.S., Pacheco J.T., Ferreira S.R., et al. Impaired reduction of nocturnal systolic blood pressure and severity of diabetic retinopathy. Exp. Clin. Cardiol. 2007;12(3):157-60.
- de la Sierra A., Redon J., Banegas J.R., et al., Spanish Society of Hypertension Ambulatory Blood Pressure Monitoring Registry Investigators. Prevalence and factors associated with circadian bloo pressure patterns in hypertensive patients. Hypertension. 2009;53(3):466-72.
- Lurbe E., Torro I., Aguilar F., et al. Added impact of obesity and insulin resistance in nocturnal blood pressure elevation in children and adolescents. Hypertension. 2008;51(3):635-41.
- Afsar B., Sezer S., Elsurer R., et al. Is HOMA index a predictor of nocturnal nondipping in hypertensives with newly diagnosed type 2 diabetes mellitus? Blood Press Monit. 2007;12(3):133-39.
- Мухин Н.А., Балкаров И.М., Шоничев Д.Г., Лебедева М.В. Формирование артериальной гипертонии при уратном тубуло-интерстициальном нефрите // Терапевтический архив. 1999. Т. 71. № 6. С. 23-27.
- Mazzali M., Hughes J., Kim Y.G., et al. Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. Hypertension. 2001;38(5):1101-06.
- Kang D.H, Nakagawa T., Feng L., et al. A role for uric acid in the progression of renal disease. J. Am. Soc. Nephrol. 2002;13(12):2888-897.
- Davidson M.B., Hix J.K., Vidt D.G., et al. Association of impaired diurnal blood pressure variation with a subsequent decline in glomerular filtration rate. Arch. Intern. Med. 2006;166(8):846-52.
- Kanellis J., Watanabe S., Li J.H., et al. Uric acid stimulates monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension. 2003;41(6):1287-93.
Supplementary files
