| [Objective]To probe into the effect of the reduced serum uric acid(SUA) levels on blood pressure(BP) control in primary non-dipper hypertensive patients with hyperuricemia(HUA).[Method]We collected a sample of 136 patients, clinically diagnosed as primary non-dipper hypertension(Type 1 or Type 2), and admitted in the No.1 Hospital of Quanzhou city during the period of April 2013 and April 2014, of which 74 are males and 64 females with an average age of 61.38±6.79. They were then randomly divided into two groups,namely HUA reduction group(n=68) and control group(n=68). All patients were given the same doze of antihypertensive felodipine retard tablets(plendil) 5mg/d, while the treatment of patients in HUA reduction group were combined with benzbromarone5mg/d. Follow-up were performed for 24 weeks, data of the serum levels of uric acid,24-hour dynamic blood pressure as well as the compliance rate of blood pressure,the discrepancy of non-dipper correction rates and the percentage of Day-night blood pressure variation between groups were observed and recorded.[Result]1. Level of serum uric acid: The SUA level of patients in HUA reduction group significantly decreased immediately after being treated(466.30 ± 60.39 pre-treatment and 344.7±39.86 post-treatment, P<0.01), while there was no significant difference in the level of SUA for patients in control group as compared(468.40±60.37 pre-treatment and 467.89±60.17 post-treatment, P=0.96).2. Ambulatory blood pressure monitoring: The post-treatment BP of patients in both groups was significantly reduced on a daily basis, neither the average daytime northe 24-hour pressure showed statistically significant difference as concluded.Meanwhile, for the HUA reduction group, on average blood pressure at night is better than that of control group(n SBP equaled 122.24±11.72 for patients in HUA reduction group and 126.99±8.11 for those in control group, P<0.01; n DBP equaled 73.66±5.02 and 77.97±3.73 respectively, P<0.01).3. No results for the compliance of 24 h SBP, 24 h DBP, d SBP and d DBP revealed any kind of significant difference in either group after treatment(36.76% compliance of24 h SBP and 24 h DBP for HUA reduction group and 33.82% for the other group, P>0.05; 30.88% compliance of d SBP and d DBP for the former and 29.41% for the latter, P> 0.05). The compliance of n SBP and n DBP, on the contrary, indicated a statistical significance for the whole experimental subjects, reaching 60.29% and 19.11%respectively at the level P<0.01.4. The proportional increase of the rates of dipping transformed into non-dipping pattern was significantly different in the HUA reduction group(55.88% for patients in HUA reduction group and 13.24% for those in control group, P<0.01).5. Compared to those in control group, the percentage discrepancy between daytime and nocturnal values of both the systolic blood pressure and the diastolic blood pressure demonstrated a distinctive ascendance for patients in HUA reduction group(the SBP readings were 8.75±7.67 for the experimental and 3.99±6.93 for the control,while the corresponding DBPs were 11.59 ± 3.42 and 4.58 ± 6.79, suggesting a statistically significant difference at P<0.01).[Conclusion]A fixed combination of the reduction in serum uric acid and antihypertensive drugs can effectively lower the overnight hypertension as well as raise the compliance of nocturnal blood pressure, and as a result, accelerate the recovery to a normal and desired reading for primary non-dipper hypertensive patients with hyperuricemia(Type 1 or... |
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