Abstract 10362: Nocturnal Diastolic Blood Pressure is Associated With 24 Hour Urinary Albumin in Essential Hypertensive Patients
Introduction: Increased nocturnal diastolic blood pressure (BP) is associated with excessive cardiovascular-risk and accumulating evidence suggests its role in progressive kidney damage which may be part of the underlying mechanism. However, clinical data on this topic are sparse. We evaluated the association between nocturnal diastolic BP and 24 hour total urinary albumin as an indicator of early microvascular kidney damage.
Methods: We recruited hypertensive patients derived from the outpatient clinic of the local tertiary care hospital. Twenty-four hour BP measurements were obtained every 15min during the day (06:00-22:00 o’clock) and every 30 min during the night (22:00-06:00). In parallel, 24h urine sampling was performed.
Results: We examined 294 hypertensive patients (age: 59.9+/-10.6 years; 52.5% females) with a mean systolic/diastolic 24-hour BP value of 128.5/76.9mmHg. In linear regression analyses adjusted for age, sex, BMI, diabetes, smoking, glomerular filtration rate and LDL-cholesterol, mean nocturnal BP was significantly associated with total 24h urinary albumin (beta-coefficient=0.173; p=0.032). This association remained materially unchanged when additionally adjusted for use of beta-blockers, ACE inhibitors, AT1 blockers, calcium antagonists, diuretics and mineralocorticoid-receptor blockers, as well as aldosterone to renin ratio and 24h urinary sodium (beta-coefficient=0.185; p=0.024;).
Conclusion: Nocturnal diastolic BP is significantly associated with albuminuria in essential hypertensive patients. This association remained significant even after multivariate adjustments considering a panel of possible confounders. These results, although observational in nature, support the hypothesis that the increased morbidity in patients with high nocturnal diastolic blood pressure may be partially mediated by pathophysiological processes related to albuminuria.
- © 2013 by American Heart Association, Inc.