Abstract：
OBJECTIVE: To investigate the association between blood pressure (BP) time in range (TIR) and composite cardiovascular outcomes in patients with primary aldosteronism (PA).
METHODS: Between January 2019 and December 2021, 47 patients with PA were recruited from the First Affiliated Hospital of Xiamen University. Twenty-four-hour ambulatory BP monitoring (ABPM) and cardiovascular outcomes were assessed in all patients during the first diagnosis of PA.
RESULTS: The mean age of the patients was 48.8 ± 11.4 years. Compared to PA without composite cardiovascular outcomes, the nighttime systolic BP TIR [31.2% (6.2%, 81.2%) vs. 11.5% (0.0%, 29.7%), p = 0.02] and defined daily dose (DDDs) of antihypertensive medication [2.0 (1.0, 2.8) vs. 1.0 (1.0, 2.0), p = 0.03] were lower in PA patients with composite cardiovascular outcomes, while higher glucose (5.0 ± 1.0 mmol/L vs. 5.9 ± 1.5 mmol/L) and prevalence of a history of alcohol intake was higher in PA patients with composite cardiovascular outcomes. There were no differences in age, sex, BMI, smoking, duration of hypertension, lipid levels, aldosteronism, clinic BP, 24-hour mean BP, daytime or nighttime BP, percentage of nocturnal SBP or DBP decline, 24-hour BP TIR, daytime BP TIR, or nighttime DBP TIR between the two groups. After adjusting for confounding factors, nighttime systolic BP TIR was significantly associated with composite cardiovascular outcomes (adjusted OR = 0.92 [95% CI 0.86, 0.99]) in multiple logistic regression analysis.
CONCLUSIONS: Nighttime systolic BP TIR was significantly associated with composite cardiovascular outcomes in patients with PA.
METHODS: Between January 2019 and December 2021, 47 patients with PA were recruited from the First Affiliated Hospital of Xiamen University. Twenty-four-hour ambulatory BP monitoring (ABPM) and cardiovascular outcomes were assessed in all patients during the first diagnosis of PA.
RESULTS: The mean age of the patients was 48.8 ± 11.4 years. Compared to PA without composite cardiovascular outcomes, the nighttime systolic BP TIR [31.2% (6.2%, 81.2%) vs. 11.5% (0.0%, 29.7%), p = 0.02] and defined daily dose (DDDs) of antihypertensive medication [2.0 (1.0, 2.8) vs. 1.0 (1.0, 2.0), p = 0.03] were lower in PA patients with composite cardiovascular outcomes, while higher glucose (5.0 ± 1.0 mmol/L vs. 5.9 ± 1.5 mmol/L) and prevalence of a history of alcohol intake was higher in PA patients with composite cardiovascular outcomes. There were no differences in age, sex, BMI, smoking, duration of hypertension, lipid levels, aldosteronism, clinic BP, 24-hour mean BP, daytime or nighttime BP, percentage of nocturnal SBP or DBP decline, 24-hour BP TIR, daytime BP TIR, or nighttime DBP TIR between the two groups. After adjusting for confounding factors, nighttime systolic BP TIR was significantly associated with composite cardiovascular outcomes (adjusted OR = 0.92 [95% CI 0.86, 0.99]) in multiple logistic regression analysis.
CONCLUSIONS: Nighttime systolic BP TIR was significantly associated with composite cardiovascular outcomes in patients with PA.
摘要：
目的：探讨原发性醛固酮增多症（PA）患者血压（BP）范围内时间（TIR）与复合心血管结局之间的关系。
方法：2019年1月至2021年12月，在厦门大学附属第一医院招募47例PA患者。在首次诊断PA期间，对所有患者进行了24小时动态血压监测（ABPM）和心血管预后评估。
结果：患者的平均年龄为48.8±11.4岁。与无复合心血管结局的PA相比，夜间收缩压血压TIR[31.2%(6.2%，81.2%)与11.5%（0.0%，29.7%），p=0.02]和定义的每日剂量（DDDs）的抗高血压药物[2.0（1.0，2.8）与1.0(1.0,2.0),P=0.03]在具有复合心血管结局的PA患者中更低，而更高的葡萄糖(5.0±1.0mmol/Lvs.5.9±1.5mmol/L），并且在具有复合心血管结局的PA患者中，饮酒史的患病率更高。年龄没有差异,性别,BMI,吸烟,高血压的持续时间，脂质水平，醛固酮增多症,临床血压,24小时平均血压,白天或夜间血压，夜间SBP或DBP下降的百分比，24小时BPTIR,白天BPTIR,或夜间DBPTIR两组。在调整混杂因素后，在多元logistic回归分析中,夜间收缩期BPTIR与复合心血管结局显著相关(校正后OR=0.92[95%CI0.86,0.99]).
结论：PA患者夜间收缩压TIR与复合心血管结局显著相关。
方法：2019年1月至2021年12月，在厦门大学附属第一医院招募47例PA患者。在首次诊断PA期间，对所有患者进行了24小时动态血压监测（ABPM）和心血管预后评估。
结果：患者的平均年龄为48.8±11.4岁。与无复合心血管结局的PA相比，夜间收缩压血压TIR[31.2%(6.2%，81.2%)与11.5%（0.0%，29.7%），p=0.02]和定义的每日剂量（DDDs）的抗高血压药物[2.0（1.0，2.8）与1.0(1.0,2.0),P=0.03]在具有复合心血管结局的PA患者中更低，而更高的葡萄糖(5.0±1.0mmol/Lvs.5.9±1.5mmol/L），并且在具有复合心血管结局的PA患者中，饮酒史的患病率更高。年龄没有差异,性别,BMI,吸烟,高血压的持续时间，脂质水平，醛固酮增多症,临床血压,24小时平均血压,白天或夜间血压，夜间SBP或DBP下降的百分比，24小时BPTIR,白天BPTIR,或夜间DBPTIR两组。在调整混杂因素后，在多元logistic回归分析中,夜间收缩期BPTIR与复合心血管结局显著相关(校正后OR=0.92[95%CI0.86,0.99]).
结论：PA患者夜间收缩压TIR与复合心血管结局显著相关。
