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首页> 外文期刊>Circulation journal >Reduction in morning blood pressure is a key factor for ameliorating urinary albumin excretion in patients with morning hypertension irrespective of treatment regimen
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Reduction in morning blood pressure is a key factor for ameliorating urinary albumin excretion in patients with morning hypertension irrespective of treatment regimen

机译：与治疗方案无关，早晨血压降低是改善早晨高血压患者尿白蛋白排泄的关键因素

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Background: The Morning Hypertension and Angiotensin Receptor Blocker/Hydrochlorothiazide Combination Therapy (MAPPY) study has shown that losartan/hydrochlorothiazide (HCTZ) combination is superior to high-dose losartan in not only reducing morning systolic blood pressure (SBP) but also ameliorating urinary albumin excretion (UAE) after 3-month treatment. The purpose of the present study was to investigate factors associated with UAE reduction in on-treatment patients with morning hypertension. Methods and Results: A total of 95 patients registered in the MAPPY study were analyzed. Patients were treated with either a losartan/HCTZ combination regimen (n=47) or a high-dose losartan regimen (n=48). Three-month treatment significantly reduced morning SBP, evening SBP, and clinic SBP (P<0.001, P<0.05, and P<0.01, respectively). UAE and serum uric acid were significantly decreased (P<0.01 for both) without the change in estimated glomerular filtration rate. Multiple linear regression analysis indicated that %morning SBP reduction and baseline UAE were independent determinants of the UAE reduction (P=0.001 for both). After adjustments for the reduction in morning-evening SBP difference, baseline UAE, and %uric acid reduction, estimated %UAE reduction level was positively correlated with the tertiles of the increasing %morning SBP reduction level (P=0.031 for trend). Moreover, subgroup analysis showed that morning SBP reduction was an independent determinant of UAE reduction in both treatment regimens. Conclusions: Reduction in morning SBP was a key factor in UAE reduction in patients with morning hypertension, irrespective of treatment regimen.
机译：背景：早晨高血压和血管紧张素受体阻滞剂/氢氯噻嗪联合治疗（MAPPY）研究表明，氯沙坦/氢氯噻嗪（HCTZ）联合治疗优于大剂量氯沙坦，不仅降低了早晨的收缩压（SBP），而且还改善了尿白蛋白治疗3个月后排泄（UAE）。本研究的目的是调查与早晨高血压治疗患者中阿联酋减少相关的因素。方法和结果：共分析了95例在MAPPY研究中注册的患者。患者接受氯沙坦/ HCTZ联合治疗（n = 47）或大剂量氯沙坦治疗（n = 48）。三个月的治疗显着降低了早晨SBP，晚上SBP和临床SBP（分别为P <0.001，P <0.05和P <0.01）。 UAE和血清尿酸显着降低（两者P均<0.01），而肾小球滤过率的估计值没有变化。多元线性回归分析表明，早晨SBP降低百分比和基线阿联酋是阿联酋降低的独立决定因素（两者均P = 0.001）。在调整了早晚SBP差异，基线阿联酋和尿酸减少量后，估计％UAE减少水平与早晨SBP减少水平增加的三分位数正相关（趋势P = 0.031）。此外，亚组分析显示，两种治疗方案中早晨SBP的降低是阿联酋降低的独立决定因素。结论：早晨SBP的降低是早晨高血压患者阿联酋降低的关键因素，与治疗方案无关。

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