Study of Nocturnal Hypertension in Patients with Chronic Kidney Disease by Office-based Blood Pressure

LI Song-yang; CHEN Song; MA Jun; WU Li-qun; YI Yang; XUAN Yi

doi:10.13730/j.issn.1009-2595.2017.07.005

Abstract：Objective To investigate the conditions of nocturnal blood pressure and the incidence of nocturnal hypertension in patients with chronic kidney disease(CKD)by office-based blood pressure.Methods A total of 530 CKD patients with normal blood pressure were selected(228 patients without hypertension,302 patients under controlled hypertension).According to the levels of office-based blood pressure,all patients were divided into normal blood pressure group(n=190)and high-normal group(n=340).The 24-hour ambulatory blood pressure was monitored by portable non-invasive blood pressure monitoring(Spacelab,USA).Results The average of nocturnal ambulatory blood pressure of 210 patients increased,and the incidence was 39.62％(210/530).Among them,88 patients were only nocturnal hypertension,and circadian blood pressure of 83 patients and nocturnal hypertension with 24-hour ambulatory mean blood pressure of 39 patients all increased.Fifty-six patients with nocturnal hypertension were found in the normal blood pressure group about 29.47％(56/190),and 154 patients with nocturnal hypertension appeared in the high-normal group about 45.29％(154/340),there was significantly difference between two groups(P<0.001).There was a higher incidence of nocturnal hypertension in CKD patients under controlled hypertension compared to CKD patients without hypertension(48％vs.28％,P<0.001).Conclusion The CKD patients under controlled hypertension have a higher incidence of nocturnal hypertension.CKD patients should use the ambulatory blood pressure monitoring in case of nocturnal hypertension or other bnomalies.It also provides a reliable basis for clinical diagnosis and treatment.