The effects of obstructive sleep apnea on blood pressure variability and load in patients with hypertension.

BACKGROUND: Hypertension frequently coexists with obstructive sleep apnea (OSA), and their interplay substantially impacts the prognosis of affected individuals. Investigating the influence of OSA on blood pressure variability (BPV) and blood pressure load (BPL) in hypertensive patients has become a focal point of clinical research. METHODS: This cross-sectional study recruited hypertensive patients (n = 265) without discrimination and classified them into four groups based on their apnea-hypopnea index (AHI): control group (n = 40), AHI < 5; mild group (n = 74), 5 ≤ AHI ≤ 15; moderate group (n = 68), 15 < AHI ≤ 30; severe group (n = 83), AHI > 30. All participants underwent comprehensive assessments, including polysomnography (PSG) monitoring, 24-h ambulatory blood pressure (ABP) monitoring, cardiac Doppler ultrasound, and additional examinations when indicated. RESULTS: BPV and BPL exhibited significant elevations in the moderate and severe OSA groups compared to the control and mild OSA groups (P < 0.05). Moreover, interventricular septum thickness and left ventricular end-diastolic volume (LVEDV) demonstrated higher values in the moderate and severe OSA groups (P < 0.05). Multiple stepwise regression analysis identified noteworthy risk factors for elevated BPV in hypertensive patients with OSA, including AHI, maximum apnea time, total times of oxygen reduction, and mean time of apnea. CONCLUSION: Hypertensive patients with moderate to severe OSA exhibited substantially increased BPV and BPL. Moreover, BPV was correlated with AHI, maximum apnea time, total times of oxygen reduction, and mean time of apnea in hypertensive patients with OSA.

Cumulative blood pressure load and hypertensive nephropathy in Han Chinese hypertensive patients.

The study aims to assess the relationship between cumulative blood pressure load (cBPL) and the risk of renal function decline in hypertensive patients and determine the blood pressure (BP) threshold required to prevent hypertensive nephropathy. A single-center prospective cohort study was conducted on hypertensive patients. The cBPL was defined as the proportion of area beyond variable BP cutoffs under ambulatory BP monitoring. Renal events were defined as > 25% (minor) or > 50% (major) decline of baseline estimated glomerular filtration rate (eGFR). Cox regression analysis was conducted between cBPL, other ambulatory BP parameters, and renal events. The results revealed a total of 436 Han Chinese hypertensive patients were eligible for enrollment. During an average follow-up period of 5.1 ± 3.3 years, a decline of > 25% and > 50% in eGFR was observed in 77 and eight participants, respectively. Cox regression analysis revealed that cSBPL140 (hazard ratio [HR], 1.102; 95% confidence interval [CI], 1.017-1.193; p = .017), cSBPL130 (HR, 1.076; 95% CI, 1.019-1.137; p = .008), and cSBPL120 (HR, 1.054; 95% CI, 1.010-1.099; p = .015) were independently associated with minor renal events. Similarly, cSBPL140 (HR, 1.228; 95% CI, 1.037-1.455; p = .017), cSBPL130 (HR, 1.189; 95% CI, 1.045-1.354; p = .009), and cSBPL120 (HR, 1.155; 95% CI, 1.039-1.285; p = .008) were independently associated with major renal events. In conclusion, cBPL is associated with renal function decline in hypertensive patients. Minimizing cBPL120 may decrease the risk of hypertensive nephropathy.

The Role of Blood Pressure Load in Ambulatory Blood Pressure Monitoring in Adults: A Literature Review of Current Evidence.

BACKGROUND: The blood pressure load (BPL) is commonly defined as the percentage of readings in a 24-h ambulatory blood pressure monitoring (ABPM) study above a certain threshold, usually the upper normal limit. While it has been studied since the 1990s, the benefits of using this index have not been clearly demonstrated in adults. We present the first review on the associations of BPL with target organ damage (TOD) and clinical outcomes in adults, the major determinants for its role and utility in blood pressure measurement. We emphasize studies which evaluated whether BPL has added benefit to the average blood pressure indices on ABPM in predicting adverse outcomes. METHODS: PubMed search for all English language papers mentioning ABPM and BPL. RESULTS: While multiple studies assessed this question, the cumulative sample size is small. Whereas the associations of BPL with various TODs are evident, the available literature fails to demonstrate a clear and consistent added value for the BPL over the average blood pressure indices. CONCLUSIONS: There is a need for prospective studies evaluating the role of BPL in blood pressure measurement. The current literature does not provide sound support for the use of BPL in clinical decisions.

Home Blood Pressure Monitoring And Nocturia In Adults.

Although widely viewed as a urological condition, nocturia has been increasingly recognized to accompany various non-urological conditions such as hypertension and blood pressure (BP) elevation on office determination. Home BP monitoring (HBPM) has been shown superior to office-based readings and provides an opportunity to assess potential relationships between nocturia and novel indices derived from multiple BP recordings including BP load, BP variability, and arterial stiffness, which have prognostic significance. We retrospectively studied 103 home BP logs and nocturia frequencies provided by 61 stable cardiology patients ≥ 21 years without medication change. Nocturnal voids ranged from 0 to 5 voids per night, median: 1.5. Nocturia frequency was significantly correlated with home and office systolic BPs and with BP load, but not with diastolic BPs, BP variability or arterial stiffness. On Poisson regression analysis, the estimated prevalence ratio (PR) for home and office systolic BPs were 1.025 (CI: 1.01, 1.04; p < .001) and 1.01 (CI:1.00, 1.02; p = .019), indicating 2.5% and 1% increases in the risk of nocturia per mmHg increases in BP respectively. In conclusion, higher mean home and office systolic BPs are associated with self-reported nocturia frequency with stronger associations seen for home BP measurement. Nocturia frequency appears unrelated to mean home and office diastolic BPs. Nocturia may be related to BP load, (percentage of elevated BP values), but not to BP variability or arterial stiffness. Future prospective studies using HBPM are needed to confirm these findings and to contribute to the understanding of the elevated BP-nocturia link.

The Correlation Between ABPM Parameters and Left Ventricular Hypertrophy in Pediatric Essential Hypertension.

Objective: To explore the association of dipping pattern and blood pressure load with left ventricular hypertrophy (LVH) in pediatric essential hypertension. Materials and Methods: Through an echocardiography monitor and an ambulatory blood pressure monitor of 425 children and adolescents diagnosed with essential hypertension with no treatment received, we identified 140 cases of LVH. Grouping patients according to LVH (LVH, N = 140; n-LVH, N = 285), we further evaluated their ambulatory blood pressure monitoring (ABPM) parameters by comparing dipping patterns between groups. A multivariable logistic regression analysis was used to determine the effect of blood pressure load on LVH. Results: No significant difference was found in systolic or diastolic blood pressure dipping patterns between groups (P = 0.161, P = 0.139). However, compared to the n-LVH group, the LVH group presented significant elevated nighttime systolic blood pressure (SBP) (P < 0.05), while nighttime DBP remained stable (P = 0.391), resulting in higher daytime and nighttime SBP loads, higher nighttime DBP load, and higher 24-h SBP load (P < 0.05). Notably, our multivariable logistic regression has shown that this trend of 24-h SBP load acts independently as a critical risk factor for LVH. Conclusion: Collectively, we observed a correlation between BP load and LVH in pediatric hypertension. Our data demonstrated that SBP load has a more significant weight in LVH progression, and 24-h SBP load, in particular, acts as a critical early prognostic parameter for LVH in pediatric hypertension.

Association between glycated hemoglobin and ambulatory blood pressure or heart rate in hypertensive patients. / é«˜è¡€åŽ‹æ‚£è€ ç³–åŒ–è¡€çº¢è›‹ç™½ä¸ŽåŠ¨æ€è¡€åŽ‹åŠå¿ƒçŽ‡çš„ç›¸å ³æ€§.

OBJECTIVES: To determine the association between glycosylated hemoglobin (HbA1c) and ambulatory blood pressure or heart rate in hypertensive patients. METHODS: A total of 585 patients, who performed ambulatory blood pressure monitoring (ABPM) from September 2018 to April 2019 in Xiangya Hospital, Central South University, were enrolled and assigned into 2 groups (470 in a hypertensive group and 115 in a normal group). HbA1c levels were compared. According to the HbA1c level, the hypertensive group was divided into 2 subgroups: A high HbA1c group (HbA1c≥6.1%, n=142) and a normal HbA1c group (HbA1c<6.1%, n=328). Whole basic data and ABPM parameter were compared among the groups. Pearson/Spearman correlation analysis was applied to study the association between HbA1c and BPV. Multivariate logistic regression was used to explore the influential factors for HbA1c (≥6.1%) and continuous increase of HbA1c in different hypertensive populations, respectively. RESULTS: The hypertensive group had higher HbA1c level than the normal group [(6.1±1.3)% vs (5.1±1.7)%, P<0.05]. In hypertensive patients, nocturnal systolic blood pressure [(131.1±19.2) mmHg vs (122.5±19.2) mmHg], nocturnal systolic blood pressure load [62.5% (15.5%-100%) vs 28.6% (0-75%)], and daytime heart rate [(74.3±11.6) min-1 vs (71.2±11.4) min-1] of the high HbA1c group were higher than those in the normal HbA1c group (all P<0.05). Pearson/Spearman correlation analysis showed that HbA1c was positively correlated with systolic blood pressure and blood pressure load (both P<0.05). Logistic regression analysis showed that nocturnal systolic pressure load was the risk factor for the increase of HbA1c level (OR=1.025, 95% CI 1.003 to 1.048, P<0.05). Multiple linear regression showed that nocturnal systolic pressure load was still positively correlated with HbA1c in total, tertiary, and hypertensive patients without treatment (ß=0.155, ß=0.171, ß=0.384, respectively, all P<0.05). CONCLUSIONS: In hypertensive patients, HbA1c is positively correlated with ambulate blood pressure, blood pressure load, and heart rate, and it has no correlation with blood pressure variability, heart rate variability, or morning blood pressure.

Blood Pressure Load: An Effective Indicator of Systemic Circulation Status in Individuals With Acute Altitude Sickness.

Background: Acute high altitude (HA) exposure results in blood pressure (BP) variations in most subjects. Previous studies have demonstrated that higher BP is potentially correlated with acute mountain sickness (AMS). The BP load may be of clinical significance regarding systemic circulation status. Objectives: This study aimed to examine HA-induced BP changes in patients with AMS compared to those in healthy subjects. Further, we provided clinical information about the relationship between variations in 24-h ambulatory parameters (BP level, BP variability, and BP load) and AMS. Methods: Sixty-nine subjects were enrolled and all participants ascended Litang (4,100 m above sea level). They were monitored using a 24-h ambulatory blood pressure device and underwent echocardiography within 24 h of altitude exposure. The 2018 Lake Louise questionnaire was used to evaluate AMS. Results: The AMS group comprised more women than men [15 (65.2%) vs. 13 (28.3%), P < 0.001] and fewer smokers [4 (17.4%) vs. 23 (50.0%), P = 0.009]. The AMS group exhibited significant increases in 24-h BP compared to the non-AMS group (24-h SBP variation: 10.52 ± 6.48 vs. 6.03 ± 9.27 mmHg, P = 0.041; 24-h DBP variation: 8.70 ± 4.57 vs. 5.03 ± 4.98 mmHg, P = 0.004). The variation of mean 24-h cBPL (cumulative BP load) (mean 24-h cSBPL: 10.58 ± 10.99 vs. 4.02 ± 10.58, P = 0.016; 24-h mean cDBPL: 6.03 ± 5.87 vs. 2.89 ± 4.99, P = 0.034) was also obviously higher in AMS subjects than in non-AMS subjects after HA exposure. 24-h mean cSBPL variation (OR = 1.07, P = 0.024) and 24-h mean cDBPL variation (OR = 1.14, P = 0.034) were independent risk factors of AMS. Moreover, variation of 24-h mean cSBPL showed a good correlation with AMS score (R = 0.504, P < 0.001). Conclusions: Our study demonstrated that patients with AMS had higher BP and BP load changes after altitude exposure than healthy subjects. Excessive BP load variations were associated with AMS. Thus, BP load could be an effective indicator regarding systemic circulation status of AMS.

Increased ambulatory arterial stiffness index and blood pressure load in normotensive obese patients.

OBJECTIVES: It has been shown that blood pressure (BP) values measured in obese subjects are higher than the individuals with normal weight, even in normotensive limits. However, data concerning the Ambulatory Arterial Stiffness Index (AASI) and blood pressure load in normotensive obese subjects is lacking. This study was aimed to compare the ambulatory arterial stiffness index and blood pressure load in normotensive obese and healthy controls. METHODS: One hundred normotensive obese and one hundred normal weight subjects were included in this study. All subjects underwent 24-hour ambulatory blood pressure monitoring. Ambulatory arterial stiffness index was calculated from 24-hour ambulatory blood pressure monitoring records. Ambulatory arterial stiffness index was defined as one minus the regression slope of unedited 24-h diastolic on systolic blood pressures. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) load values were calculated from 24-hour ambulatory blood pressure monitoring analysis. RESULTS: Ambulatory arterial stiffness index of the obese subjects was significantly higher than the healthy controls (0.48±0.2 vs. 0.33±0.11, p<0.001). 24-hours systolic blood pressure and diastolic blood pressure loads were significantly higher in obese subjects. Logistic regression analysis revealed that body mass index (BMI) was an independent predictor for an abnormal ambulatory arterial stiffness index (≥0.50) (OR: 1.137, 95% CI: 0.915-1.001, p=0.004). CONCLUSION: Blood pressure load and ambulatory arterial stiffness index are increased in normotensive obese patients. Moreover, body mass index is an independent predictor for an abnormal ambulatory arterial stiffness index. Our results indicate that obese subjects are at higher risk for future cardiovascular events despite normal office BP levels.

Association between glycated hemoglobin and ambulatory blood pressure or heart rate in hypertensive patients / 中南大学学报(医学版)

OBJECTIVES@#To determine the association between glycosylated hemoglobin (HbA1c) and ambulatory blood pressure or heart rate in hypertensive patients.@*METHODS@#A total of 585 patients, who performed ambulatory blood pressure monitoring (ABPM) from September 2018 to April 2019 in Xiangya Hospital, Central South University, were enrolled and assigned into 2 groups (470 in a hypertensive group and 115 in a normal group). HbA1c levels were compared. According to the HbA1c level, the hypertensive group was divided into 2 subgroups: A high HbA1c group (HbA1c≥6.1%, @*RESULTS@#The hypertensive group had higher HbA1c level than the normal group [(6.1±1.3)% vs (5.1±1.7)%, @*CONCLUSIONS@#In hypertensive patients, HbA1c is positively correlated with ambulate blood pressure, blood pressure load, and heart rate, and it has no correlation with blood pressure variability, heart rate variability, or morning blood pressure.

[Effect of acupuncture at Renying (ST 9) on blood pressure in patients with ischemic stroke complicated with essential hypertension].

OBJECTIVE: To observe the effect of acupuncture at Renying (ST 9) on morning blood pressure, daytime peak blood pressure and 24-hour blood pressure load in patients with ischemic stroke complicated with essential hypertension. METHODS: A total of 80 patients (3 cases dropped off) were randomized into an observation group (39 cases) and a control group (38 cases). Xingnao Kaiqiao acupuncture and nifedipine were given in the control group. On the basis of treatment in the control group, acupuncture at Renying (ST 9) was applied in the observation group, once a day, 6 times a week for 4 weeks. The changes of morning blood pressure, daytime peak blood pressure and blood pressure load were observed before and after treatment in the two groups. RESULTS: Compared before treatment, morning blood pressure, daytime peak blood pressure and blood pressure load after treatment were reduced in the two groups (all P<0.05). The change of morning systolic pressure in the observation group was not significant as compared with that in the control group (P>0.05); the changes of morning diastolic pressure, daytime peak blood pressure and blood pressure load in the observation group were larger than those in the control group (all P<0.05). CONCLUSION: On the basis of Xingnao Kaiqiao acupuncture and nifedipine, acupuncture at Renying (ST 9) can effectively reduce morning blood pressure, daytime peak blood pressure and blood pressure load in patients with ischemic stroke complicated with essential hypertension.

[Relationship between systolic blood pressure load and sleep stability in patients with essential hypertension].

Objective: To explore the relationship between blood pressure load and sleep stability in hypertensive patients by cardiopulmonary coupling monitoring (CPC) and 24-hour ambulatory blood pressure monitoring. Methods: One hundred and fifty-five patients with essential hypertension were divided into high load group and low load group according to whether the blood pressure load was higher than 50%. The relationship between sleep stability and systolic blood pressure load was analyzed by logistic regression. Results: After adjusting for sex, age and body mass index (BMI), logistic regression analysis showed that stable sleep was the protective factor (OR=0.736,P=0.047) for the decrease of nocturnal blood pressure load, and unstable sleep was the risk factor for increasing day time blood pressure load (OR=1.336, P=0.037) in patients with hypertension. Conclusions: The effect of sleep stability on blood pressure load is different between day and night. Stable sleep is the protective factor of nocturnal systolic blood pressure load decrease, and unstable sleep is the harmful factor of daytime systolic blood pressure load increase. Increasing sleep stability helps to reduce systolic blood pressure load.

[Effect of " Huoxue Sanfeng acupuncture" auxiliary therapy on morning blood pressure and blood pressure load in elderly patients with stroke complicated with hypertension].

OBJECTIVE: To observe the effects of "Huoxue Sanfeng acupuncture" auxiliary therapy on neurological function, blood pressure load and morning blood pressure in elderly patients with stroke complicated with hypertension, on the basis of "Xingnao Kaiqiao acupuncture" combined with nifedipine. METHODS: Seventy patients with stroke complicated with hypertension were randomly divided into an observation group and a control group, 35 cases in each group. "Xingnao Kaiqiao acupuncture" and conventional nifedipine controlled release tablets were given in the control group. Regarding regaining consciousness with acupuncture, the main acupoint is Shuigou (GV 26), combined with Neiguan (PC 6) and Sanyinjiao (SP 6), retaining needle for 20 min, additionally, the quick needling technique was applied to Shangjiquan (Extra), Chize (LU 5) and Weizhong (BL 40) of the affected side, nifedipine controlled release tablets were orally administered 30 mg once a day for a total of 6 weeks. The "Huoxue Sanfeng acupuncture" was added on the basis treatment in the observation group, the acupuncture was applied at Renying (ST 9) as the main acupoint, combined with Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3). The strict manipulation quantitative acupuncture was used and the needle was retained for 20 min. Both acupuncture methods were performed once a day, 5 times a week, and continued treatment at intervals of 2 days, 10 times for one course, and a total of 3 courses were needed. The morning blood pressure and 24 h blood pressure load were measured before and after treatment. The National Institute of Health stroke scale (NIHSS) score and the Barthel index (BI) classification were observed before and after treatment. RESULTS: The systolic and diastolic blood pressures were significantly lower than those before treatment in the two groups (all P<0.01), and the systolic and diastolic blood pressures in the observation group were lower than those in the control group (both P<0.01). There was no significant difference between the difference of systolic blood pressure before and after treatment in the two groups (P>0.05), and the difference of the diastolic blood pressure before and after treatment in the observation group was higher than that in the control group (P<0.01). The systolic and diastolic pressures load in the two groups were lower than those before treatment (all P<0.01), and the systolic and diastolic pressures load in the observation group were lower than those in the control group (both P<0.05), the difference of systolic and diastolic pressure load before and after treatment in the observation group were higher than those in the control group (both P<0.05). After treatment, the NIHSS scores in the two groups were lower than those before treatment (both P<0.01). The NIHSS scores in the observation group were lower than those in the control group (P<0.05). The difference of NIHSS scores before and after treatment in the observation group was higher than that in the control group (P<0.01). After treatment, the BI grading was better than that before treatment in the two groups (both P<0.05), and the BI grading in the observation group was superior to that in the control group (P<0.05). CONCLUSION: On the basis of "Xingnao Kaiqiao acupuncture" combined with nifedipine controlled release tablets in the treatment of elderly patients with stroke complicated with hypertension, "Huoxue Sanfeng acupuncture" can further improve the function of nerve and limbs, effectively reduce the morning blood pressure level of elderly patients, especially diastolic blood pressure, and significantly improve systolic blood pressure and diastolic blood pressure load.

Effect of acupuncture at Renying (ST 9) on blood pressure in patients with ischemic stroke complicated with essential hypertension / 中国针灸

OBJECTIVE@#To observe the effect of acupuncture at Renying (ST 9) on morning blood pressure, daytime peak blood pressure and 24-hour blood pressure load in patients with ischemic stroke complicated with essential hypertension.@*METHODS@#A total of 80 patients (3 cases dropped off) were randomized into an observation group (39 cases) and a control group (38 cases). acupuncture and nifedipine were given in the control group. On the basis of treatment in the control group, acupuncture at Renying (ST 9) was applied in the observation group, once a day, 6 times a week for 4 weeks. The changes of morning blood pressure, daytime peak blood pressure and blood pressure load were observed before and after treatment in the two groups.@*RESULTS@#Compared before treatment, morning blood pressure, daytime peak blood pressure and blood pressure load after treatment were reduced in the two groups (all 0.05); the changes of morning diastolic pressure, daytime peak blood pressure and blood pressure load in the observation group were larger than those in the control group (all <0.05).@*CONCLUSION@#On the basis of acupuncture and nifedipine, acupuncture at Renying (ST 9) can effectively reduce morning blood pressure, daytime peak blood pressure and blood pressure load in patients with ischemic stroke complicated with essential hypertension.

Effect of " acupuncture" auxiliary therapy on morning blood pressure and blood pressure load in elderly patients with stroke complicated with hypertension / 中国针灸

OBJECTIVE@#To observe the effects of " acupuncture" auxiliary therapy on neurological function, blood pressure load and morning blood pressure in elderly patients with stroke complicated with hypertension, on the basis of " acupuncture" combined with nifedipine.@*METHODS@#Seventy patients with stroke complicated with hypertension were randomly divided into an observation group and a control group, 35 cases in each group. " acupuncture" and conventional nifedipine controlled release tablets were given in the control group. Regarding regaining consciousness with acupuncture, the main acupoint is Shuigou (GV 26), combined with Neiguan (PC 6) and Sanyinjiao (SP 6), retaining needle for 20 min, additionally, the quick needling technique was applied to Shangjiquan (Extra), Chize (LU 5) and Weizhong (BL 40) of the affected side, nifedipine controlled release tablets were orally administered 30 mg once a day for a total of 6 weeks. The " acupuncture" was added on the basis treatment in the observation group, the acupuncture was applied at Renying (ST 9) as the main acupoint, combined with Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3). The strict manipulation quantitative acupuncture was used and the needle was retained for 20 min. Both acupuncture methods were performed once a day, 5 times a week, and continued treatment at intervals of 2 days, 10 times for one course, and a total of 3 courses were needed. The morning blood pressure and 24 h blood pressure load were measured before and after treatment. The National Institute of Health stroke scale (NIHSS) score and the Barthel index (BI) classification were observed before and after treatment.@*RESULTS@#The systolic and diastolic blood pressures were significantly lower than those before treatment in the two groups (all 0.05), and the difference of the diastolic blood pressure before and after treatment in the observation group was higher than that in the control group (<0.01). The systolic and diastolic pressures load in the two groups were lower than those before treatment (all <0.01), and the systolic and diastolic pressures load in the observation group were lower than those in the control group (both <0.05), the difference of systolic and diastolic pressure load before and after treatment in the observation group were higher than those in the control group (both <0.05). After treatment, the NIHSS scores in the two groups were lower than those before treatment (both <0.01). The NIHSS scores in the observation group were lower than those in the control group (<0.05). The difference of NIHSS scores before and after treatment in the observation group was higher than that in the control group (<0.01). After treatment, the BI grading was better than that before treatment in the two groups (both <0.05), and the BI grading in the observation group was superior to that in the control group (<0.05).@*CONCLUSION@#On the basis of " acupuncture" combined with nifedipine controlled release tablets in the treatment of elderly patients with stroke complicated with hypertension, " acupuncture" can further improve the function of nerve and limbs, effectively reduce the morning blood pressure level of elderly patients, especially diastolic blood pressure, and significantly improve systolic blood pressure and diastolic blood pressure load.

Prognostic value of nighttime blood pressure load in Chinese patients with nondialysis chronic kidney disease.

The prognostic value of nighttime blood pressure (BP) load in patients with chronic kidney disease (CKD) remains unknown. The prognostic value of nighttime BP load in a cohort of Chinese patients with nondialysis CKD was investigated. The authors monitored ambulatory BP and followed health outcomes in 588 Chinese CKD patients. Multivariable-adjusted Cox regression analyses indicated that nighttime BP load was a significant risk factor for all clinical outcomes in CKD patients, even when adjusted for clinic BP. Tertile 3 of systolic BP load (vs tertile 1) was associated with an increased risk of renal events (hazard ratio [HR], 2.21; 95% confidence interval [CI], 1.12-4.38) and cardiovascular events (HR, 5.34; 95% CI, 1.58-18.04); tertile 3 of diastolic BP load (vs tertile 1) was associated with an increased risk of all-cause mortality (HR, 6.73; 95% CI, 1.79-25.20), cardiovascular mortality (HR, 7.18; 95% CI, 1.47-35.03), renal events (HR, 2.40; 95% CI, 1.17-4.92), and cardiovascular events (HR, 5.87; 95% CI, 1.97-17.52). Higher nighttime BP load, especially nighttime diastolic BP load, was associated with a poorer prognosis in Chinese nondialysis CKD patients.

Relationship between left ventricular hypertrophy and blood pressure load and circadian rhythm in hypertension / 医学研究生学报

Objective: To investigate the association between the left ventricular hypertrophy (LVH) and blood pressure load (BPL) and circadian rhythm in hypertensive patients. Methods:Sixty patients with hypertension were studied by 24-hour ambulatory blood pressure monitoring ( ABPM) and colour Doppler echocardiography. Results: Daytime、 nighttime and 24-hour systolic blood pressure load (d-SBPL、n-SBPL、24h-SBPL) in hypertensive patients with LVH were significantly higher than those without LVH[(88.4?11.6) vs (79. 8?13. 4) ,P