| Objective:To explore the correlation between high sensitive C-reactiv-e protein(hs-CRP),micro-albuminuria and brachial-ankle pulse wave velocit-y(baPWV) in non-dipper hypertension. Methods:135cases of hyperten-sive patients with blood pressure level1-3hospitalized in the First Affili-ated Hospital of Guangxi Medical University from October2012to Dece-mber2013were selected. The inclusion criteria was matched with the pr-ovision of the2010Chinese hypertension guidelines and patients with se-condary hypertension, chronic renal insufficiency, complicated with seriou-s heart, lung and liver disease were excluded.71male and64female age-d42to76years were included. Total cholesterol, triglycerides, highdensi-ty lipoprotein, low-density lipoprotein, liver and kidney function, blood ur -ea nitrogen, fasting and2-hour postprandial blood glucose,24-hour micro-albuminuria hs-CRP, baPWV and ambulatory blood pressure monitoring w-ere performed among all the hypertensive patients. According to the res-ults of24-hour ambulatory blood pressure monitoring,the patients are div-ided into dipper hypertension group (the average nighttime systolic or di-astolic blood pressure decreased between10%and20%than the average daytime systolic or diastolic) and non-dipper hypertension group (the avera-ge nighttime systolic or diastolic blood pressure decreased less than10%or greater than20%than the average daytime systolic or diastolic), and the test results of the two groups were comparatively studied. Results:①No significant difference between the two groups at baseline characteri-sties such as age, male/female ratio, height, sitting blood pressure, body mass index(BMI), abdominal circumference, smoking/non-smoking populati-on, duration etc (P>0.05).②No significant difference in triglyceride, hig-hdensity lipoprotein, total cholesterol, low-density lipoprotein, serum creati-nine, plasma non-protein nitrogen levels (P>0.05).③Compared with the dipper hypertension group,24-hour micro-albuminuria, hs-CRP and baPWV were significantly increased (15.29±5.4mg/L vs26.44±12.33mg/,1.63±0.63mg/L vs2.60±0.54mg/L,1664.5±173.08cm/s vs2252.1±338.1cm/s, P<0.05) in the non-dipper hypertension group.④Compared with the dipper hy-pertension group, the average nighttime systolic and diastolic pressure an d24hour ambulatory pulse pressure were significantly increased (115.80±12.17mmHg vs123.43±13.48mmHg,70.94±12.34mmHg vs76.35±11.97mm,59.46±9.61mmHg vs65.13±11.83mmHg, P<0.05),and the average dayt-ime diastolic pressure was lower (84.24±13.3mmHg vs79.95±11.63mmHg, P<0.05) in the non-dipper hypertension group, but there were no signifi -cant difference in the24-hour average systolic and diastolic pressure and average daytime systolic pressure (P>0.05).⑤Correlation analysis showe-d that hs-CRP, micro-albuminuria were positively correlated with baPWV, with a correlation coefficient of0.25and0.33respectively.⑥Multiple li-near regression analysis showed that hs-CRP as independent variable(X1), micro-albuminuria as the independent (X2), baPWV as the dependent vari-able(Y), the resulting regression equation was Y=466.3X1+92.5X2+776.3(F=8.39,R2=0.113). Conclusion:The nighttime blood pressure levels were si-gnificantly higher in non-dipper hypertension than that of the dipper ones, and micro-albuminuria and brachial ankle pulse wave velocity significantl-y increased also. Hs-CRP and micro-albuminuria were positively correlate-d with baPWV. Blood pressure abnormal rhythm and inflammation joint action may be one of the mechanisms triggering the formation of clinical proteinuria in non-dipper hypertension patients with atherosclerosis. |
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