Short-term Effect Of Anti-tuberculosis Treatment On Blood Pressure Of Patients And Related Factors Research

Objective(s): To explore the short-term effects of anti-tuberculosis treatment(ATT)on blood pressure of tuberculosis(TB)patients and the related factors affecting blood pressure changes,so as to provide evidence for blood pressure monitoring and treatment intervention during ATT.Methods: This study is prospective observational study,including treatment-naive TB patients treated in Infection Department of 920 th Hospital of Joint Logistics Support Force from December 2021 to December 2022.The study was approved by the hospital ethics record,with the approval number: Lun sheng2022-103(Section)-01.Demographic and clinical characteristics of patients were collected.The blood pressure data of patients before ATT,1th,3th,7th and 14 th day of treatment were monitored.Blood routine,blood biochemistry and other laboratory data were collected before medication,7th and 14 th day of treatment.SPSS 25.0 was used for statistical analysis and Graphpad Prism 5.0 was used for drawing.To analyze the incidence of hypertension in the TB population,the dynamic changes of blood pressure after ATT;the proportion of patient developed hypertension,and the risk factors associated with elevated blood pressure.Results: 1.A total of 145 hospitalized patients with treatment-native tuberculosis patients were included in this study,complicated with hypertension were19.31 %(28 / 145).On the 14 th day of ATT,64.14 %(93 / 145)of patients had elevated systolic blood pressure,and 44.09 %(41 / 93)of patients had elevated blood pressure ≥10 mm Hg.in the total population(n=145),the systolic blood pressure on the 7th day(120.21±15.37 vs.116.97±16.46 mm Hg,P=0.005)and 14 th day(121.14±15.43 vs.116.97±16.46 mm Hg,P<0.001)of ATT and diastolic blood pressure on the 14 th day(78.49±9.58 vs.75.93±10.20 mm Hg,P=0.003)of ATT were significantly higher than baseline.2.According to weather complicated with hypertension at baseline,145 patients were divided into a TB with hypertension group(n=28)and TB Without hypertension group(n=117).The Age [55(44,71)vs.45(30,56),P=0.001],body mass index(23.86±3.68 vs.21.82±2.97,P=0.001),P=0.002),baseline systolic blood pressure(138.82±14.28 vs.111.74±12.08 mm Hg,P<0.001),baseline diastolic blood pressure(88.11±7.24 vs.73.02±8.52 mm Hg,P<0.001)in the TB with hypertension group were significantly higher than those without hypertension group;In the with hypertension group,the diastolic blood pressure on the 3th day of ATT was significant lower than baseline(85.18±8.92 vs.88.11±7.24 mm Hg,P=0.034).In the Without hypertension group,the systolic blood pressure on the 3th(113.74±12.03 vs.111.74±12.08 mm Hg,P=0.032),7th day(116.44±12.41 vs.111.74±12.08 mm Hg,P<0.001),14 th day(117.15±12.56 vs.111.74±12.08 mm Hg,P<0.001)of ATT,diastolic blood pressure on the 7th day(75.10±9.67 vs.73.02±8.53 mm Hg,P=0.029),14 th day(75.57±8.83 vs.73.02±8.53 mm Hg,P<0.001)were significantly higher than baseline.3.In the Without hypertension group,the proportion of developed hypertension on3 th,7th,14 th days after ATT was 3.42%(4/117),12.82%(15/117)and20.5%(24/117).According to weather developed hypertension after ATT the patients were divided into Development hypertension group(DH)and Non-development hypertension group(Non-DH).baseline uric acid,baseline systolic blood pressure,and baseline diastolic blood pressure were included in the multivariate logistics regression analysis,the results showed that: Baseline systolic blood pressure(OR=1.07,95%CI.1.01-1.14,P=0.032)and baseline uric acid(OR=1.02,95%CI.1.01-1.03,P=0.020)were risk factors for developed hypertension after ATT.In the Without hypertension group,including the patients with baseline,7th day,14 th day uric acid and blood pressure data monitors(n=88),uric levels were significantly associated with blood pressure(r=0.179,P=0.004).Conclusion(s): The blood pressure of treatment-native TB patients elevated after short-term ATT.In the without hypertension group,the systolic blood pressure level showed a gradual upward trend with the ATT time,and 20.51% of the patients blood pressure elevated to the level of hypertension.Baseline blood pressure and baseline uric acid level are related risk factors of development hypertension after ATT,Strengthening the management and intervention of blood pressure elevation risk factors may reduce the trend of blood pressure elevation after ATT and significance for the successful completion of ATT.