Relationship between blood pressure variability and hyperuricemia in patients with essential hypertension

doi:10.11958/20220971

Abstract

Abstract:

Objective To analyze the relationship between blood pressure variability (BPV) and hyperuricemia in patients with essential hypertension. Methods A total of 197 patients with essential hypertension were divided into the non-hyperuricemia group (n=143) and the hyperuricemia group (n=54) according to whether they were accompanied by hyperuricemia. The participants were divided into four groups according to the serum uric acid (SUA) quartile, the group Q1 (n=49) with SUA≤282.35 μmol/L, the group Q2 (n=50) with 282.35 μmol/L < SUA≤332.40 μmol/L, the group Q3 (n=49) with 332.40 μmol/L < SUA≤406.65 μmol/L, the group Q4 (n=49) with SUA > 406.65 μmol/L. All patients completed 24-hour ambulatory blood pressure monitoring within 3 days of admission. The general data, biochemical indexes and blood pressure related indexes were collected and compared between the two groups. LASSO regression was used to screen the predictors of hyperuricemia. Multivariate Logistic regression analysis was used to test risk factors of hyperuricemia. Results The prevalence of hyperuricemia in patients with essential hypertension was 27.4%. Compared with the non-hyperuricemia group, the proportion of males and hypertension grade were higher in the hyperuricemia group, and the levels of body mass index (BMI), triglyceride (TG), serum creatinine (Scr), blood urea nitrogen (BUN) and uric acid (SUA) were increased. Glycated hemoglobin A1c (HbA1c), high density lipoprotein cholesterol (HDL-C), uric acid excretion fraction (FEUA) and estimated glomerular filtration rate (eGFR) were decreased in the hyperuricemia group (P<0.05). With the increase of hypertension grade, the proportion of the Q2 group gradually decreased, while the proportion of the Q4 group gradually increased, and the difference in trend change was statistically significant (χ²=4.578, P<0.05). Compared with the non-hyperuricemia group, the mean daytime diastolic blood pressure (DDBPX), mean nighttime diastolic blood pressure (NDBPX), weighted standard deviation of diastolic blood pressure (DBPwSD) and heart rate variability (HRV) were significantly increased in the hyperuricemia group (P<0.05). LASSO regression was used to select hypertension grade, DBPwSD, TG, eGFR and FEUA as independent variables. Logistic regression analysis demonstrated that elevated levels of DBPwSD and TG were risk factors for hyperuricemia, and elevated levels of eGFR and FEUA were protective factors for hyperuricemia. Conclusion Diastolic BPV is an independent risk factor for hyperuricemia in hypertensive patients.

Key words: hypertension, hyperuricemia, blood pressure determination, blood pressure variability, diastole

CLC Number:

R589.7，R544.1

Figures/Tables 6

References 32

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组别	n		年龄（岁）		男性	高血压分级					BMI （kg/m²）		HbA1c （%）		TC （mmol/L）		HDL-C（mmol/L）
组别	n		年龄（岁）		男性	1级		2级		3级	BMI （kg/m²）		HbA1c （%）		TC （mmol/L）		HDL-C（mmol/L）
无高尿酸血症组	143		57.4±10.6		99（69.2）	14（9.8）		51（35.7）		78（54.5）	27.2（24.6，29.7）		8.1（7.1，9.2）		4.68（4.08，5.49）		1.13（0.99，1.28）
高尿酸血症组	54		56.4±11.1		45（83.3）	1（1.9）		10（18.5）		43（79.6）	28.2（26.2，31.2）		7.2（6.6，8.2）		5.10（4.18，5.85）		1.07（0.90，1.21）
χ²、t或Z			0.588		3.964^＊	10.981^＊					2.063^＊		3.094^＊＊		0.999		2.361^＊
组别		LDL-C （mmol/L）		TG （mmol/L）			Scr （μmol/L）		BUN （mmol/L）			SUA （μmol/L）		FEUA （%）		eGFR [mL/（min·1.73 m²）]
无高尿酸血症组		3.16±0.86		1.53（1.04，2.27）			67.6±14.9		5.47（4.38，6.39）			308.0（264.1，341.9）		7.0（5.9，8.4）		116.6±27.4
高尿酸血症组		3.14±0.99		2.47（1.58，8.04）			85.6±19.0		5.94（5.10，8.04）			458.9（422.2，507.8）		4.9（4.0，6.5）		91.0±23.9
χ²、t或Z		0.111		4.050^＊＊			7.018^＊＊		3.092^＊＊			9.909^＊＊		6.166^＊＊		6.061^＊＊

组别	n		年龄（岁）		男性	高血压分级					BMI （kg/m²）		HbA1c （%）		TC （mmol/L）		HDL-C（mmol/L）
组别	n		年龄（岁）		男性	1级		2级		3级	BMI （kg/m²）		HbA1c （%）		TC （mmol/L）		HDL-C（mmol/L）
无高尿酸血症组	143		57.4±10.6		99（69.2）	14（9.8）		51（35.7）		78（54.5）	27.2（24.6，29.7）		8.1（7.1，9.2）		4.68（4.08，5.49）		1.13（0.99，1.28）
高尿酸血症组	54		56.4±11.1		45（83.3）	1（1.9）		10（18.5）		43（79.6）	28.2（26.2，31.2）		7.2（6.6，8.2）		5.10（4.18，5.85）		1.07（0.90，1.21）
χ²、t或Z			0.588		3.964^＊	10.981^＊					2.063^＊		3.094^＊＊		0.999		2.361^＊
组别		LDL-C （mmol/L）		TG （mmol/L）			Scr （μmol/L）		BUN （mmol/L）			SUA （μmol/L）		FEUA （%）		eGFR [mL/（min·1.73 m²）]
无高尿酸血症组		3.16±0.86		1.53（1.04，2.27）			67.6±14.9		5.47（4.38，6.39）			308.0（264.1，341.9）		7.0（5.9，8.4）		116.6±27.4
高尿酸血症组		3.14±0.99		2.47（1.58，8.04）			85.6±19.0		5.94（5.10，8.04）			458.9（422.2，507.8）		4.9（4.0，6.5）		91.0±23.9
χ²、t或Z		0.111		4.050^＊＊			7.018^＊＊		3.092^＊＊			9.909^＊＊		6.166^＊＊		6.061^＊＊

组别		n	DSBPX （mmHg）		DDBPX （mmHg）		NSBPX （mmHg）		NDBPX （mmHg）
无高尿酸血症组		143	142±15		79±10		136±18		74±11
高尿酸血症组		54	144±17		83±13		139±18		78±13
t或Z			0.922		2.120^＊		1.001		2.089^＊
组别	SBPwSD			DBPwSD		HRX（次/min）		HRV
无高尿酸血症组	15.4±4.7			10.9±3.2		73±8		7.7（6.2，9.7）
高尿酸血症组	16.7±5.0			12.0±3.5		76±10		8.5（7.3，10.6）
t或Z	1.656			1.978^＊		1.733		2.043^＊

组别		n	DSBPX （mmHg）		DDBPX （mmHg）		NSBPX （mmHg）		NDBPX （mmHg）
无高尿酸血症组		143	142±15		79±10		136±18		74±11
高尿酸血症组		54	144±17		83±13		139±18		78±13
t或Z			0.922		2.120^＊		1.001		2.089^＊
组别	SBPwSD			DBPwSD		HRX（次/min）		HRV
无高尿酸血症组	15.4±4.7			10.9±3.2		73±8		7.7（6.2，9.7）
高尿酸血症组	16.7±5.0			12.0±3.5		76±10		8.5（7.3，10.6）
t或Z	1.656			1.978^＊		1.733		2.043^＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
DBPwSD	0.158	0.072	4.891	0.027	1.172	1.018~1.348
TG	0.430	0.129	11.127	0.001	1.537	1.194~1.978
eGFR	-0.077	0.014	30.746	0.001	0.926	0.901~0.951
FEUA	-0.985	0.172	32.872	0.001	0.373	0.267~0.523
常数项	10.171	1.936	27.587	0.001	26 124.755