A6769 Rule of 24 h Ambulatory Blood Pressure in Hypertensive Patients with “Hyper-filtration” Renal Damage

Abstract

Objectives: To explore the rule of 24 h ambulatory blood pressure(AMBP) in hypertensive patients with “hyper-filtration” stage renal damage. Methods: A total of 513 untreated hypertensive patients with no complications were collected, and 376 patients were selected according to estimated glomerular filtration rate (eGFR≥90,unit:ml/min/1.73m2). Patients were divided into high filtration group (n = 102, eGFR≥120) and normal filtration group(n = 274, 90≤eGFR < 120), and several subgroups based on their levels of urinary microalbumin-to-creatitine ratio(UACR) from low to high. The variation of AMBP had been compared in each group. Results: In two groups, the levels of urea nitrogen, triglyceride, total cholesterol and low density lipoprotein were not significantly increased with the increase of UACR. After adjusting for age and gender, mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), nocturnal mean systolic blood pressure (nSBP), nocturnal mean diastolic pressure (nDBP) were higher with the increase of UACR within each group, especially nDBP(P < 0.05). When UACR was positive(30 mg/g≤UACR≤300 mg/g), nSBP and nDBP were significantly higher, and the high filtration rate group was more obvious (P < 0.05). After adjusting for age and gender, even if the UACR was within the normal range, the circadian blood pressure became abnormal in both groups; as UACR increases, the proportion of patients with abnormal blood pressure rhythm significantly increased. And once UACR was ≥30 mg/g, nSBP and nDBP decreased significantly within each group; more than 90% of patients lost normal blood pressure rhythm (P < 0.05). Conclusion: Nocturnal blood pressure was elevated and abnormal circadian rhythm occurred as hypertensive patients developed into “hyper-filtration” stage, whereas UACR was still within the normal range.