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中华肾病研究电子杂志 ›› 2014, Vol. 03 ›› Issue (02) : 65 -67. doi: 10.3877/cma.j.issn.2095-3216.2014.02.002

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慢性肾脏病血压管理应重视血压昼夜节律异常
何娅妮,1, 林利容1   
  1. 1.400042 重庆第三军医大学第三附属医院野战外科研究所肾内科
  • 出版日期:2014-04-15
  • 通信作者: 何娅妮

Attention to circadian rhythm abnormalities in managing blood pressure of patients with chronic kidney disease

Yani He,1, Lirong Lin1   

  1. 1.Department of Nephrology, Daping Hospital, Research Institute of Surgery, the Third Military Medical University. Chongqing 400042, China
  • Published:2014-04-15
  • Corresponding author: Yani He
引用本文:

何娅妮, 林利容. 慢性肾脏病血压管理应重视血压昼夜节律异常[J/OL]. 中华肾病研究电子杂志, 2014, 03(02): 65-67.

Yani He, Lirong Lin. Attention to circadian rhythm abnormalities in managing blood pressure of patients with chronic kidney disease[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2014, 03(02): 65-67.

血压昼夜节律异常是高血压患者心脑血管事件的强预报因子。 在慢性肾脏病(CKD)患者中,无论血压水平是否正常,血压昼夜节律异常十分普遍,并且是CKD 进展、心血管并发症的独立危险因素。 在CKD 的血压管理上,除了控制血压水平达标,更应重视对夜间血压及昼夜节律的监测、评估和积极干预。 主要措施包括24 h 动态血压监测、改变生活习惯、限盐、联合使用降压药物以及睡前服药等。

The circadian rhythm abnormalities of blood pressure are potent predictors of cardiovascular and cerebrovascular events in patients with hypertension. In patients with chronic kidney disease (CKD), regardless of whether their blood pressure levels are normal or not, the abnormal circadian rhythm of blood pressure is very common, and is an independent risk factor for CKD progression and cardiovascular complications, Therefore, during the management of bood pressure in patients with CKD, in addition to standard control of blood pressure levels, more attention should be paid to the monitoring,evaluation, and active intervention of nocturnal blood pressure and the circadian rhythm of blood pressure.The main measures include 24-hour ambulatory blood pressure monitoring, lifestyle changes, salt restriction,joint use of antihypertensive medication,and medicine-taking at bedtime.

1
Hermida RC, Ayala DE, Mojón A, Fernández JR. Blunted sleep-time relative blood pressure decline increases cardiovascular risk independent of blood pressure level-the “normotensive nondipper” paradox [J]. Chronobiol Int,2013,30(1-2):87-98.
2
Soylu A, Yazici M, Duzenli MA, et al. Relation between abnormalities in circadian blood pressure rhythm and target organ damage in normotensives [J]. Circ J,2009,73(5):899-904.
3
Mojón A,Ayala DE,Piñeiro L,et al. Comparison of ambulatory blood pressure parameters of hypertensive patients with and without chronic kidney disease [J]. Chronobiol Int,2013,30(1-2):145-158.
4
Mancia G, Fagard R, Narkiewicz K, et al. 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology(ESC): ESH/ESC task force for the management of arterial hypertension [J]. J Hypertens,2013,31(10):1925-1938.
5
Hermida RC, Smolensky MH, Ayala DE, et al. Abnormalities in chronic kidney disease of ambulatory blood pressure 24 h patterning and normalization by bedtime hypertension chronotherapy [J].Nephrol Dial Transplant,2013, Sep 5. [Epub ahead of print].
6
Iimuro S, Imai E, Watanabe T, et al. Clinical correlates of ambulatory BP monitoring among patients with CKD [J]. Clin J Am Soc Nephrol,2013,8(5):1-10.
7
Davidson MB,Hix JK,Vidt DG,Brotman DJ. Association of impaired diurnal blood pressure variation with a subsequent decline in glomerular filtration rate [J]. Arch Intern Med,2006,166(8):846-852.
8
Redon J, Plancha E, Swift PA, et al. Nocturnal blood pressure and progression to end-stage renal disease or death in nondiabetic chronic kidney disease stages 3 and 4 [J]. J Hypertens,2010,28(3):602-607.
9
Lin L,He Y. Contributing factors for circadian rhythm variation of blood pressure in adult IgAN patients[J]. J Am Soc Nephrol,2013,24:421A.
10
Lurbe E, Redon J, Kesani A, et al. Increase in nocturnal blood pressure and progression to microalbuminuria in type 1 diabetes[J].N Engl J Med,2002,347(11):797-805.
11
Goswami P, Drawz P, Rahman M. Nocturnal dosing and chronic kidney disease progression: new insights [J]. Curr Opin Nephrol Hypertens,2009,18(5):381-385.
12
Tsioufis C, Andrikou I, Thomopoulos C, et al. Comparative prognostic role of nighttime blood pressure and nondipping profile on renal outcomes [J]. Am J Nephrol,2011,33(3):277-288.
13
Cohen DL, Huan Y, Townsend RR. Townsend. Ambulatory Blood Pressure in Chronic Kidney Disease[J]. Curr Hypertens Rep,2013,15(3):160-166.
14
de la Sierra A, Gorostidi M, Banegas JR, et al. Nocturnal hypertension or nondipping: which Is better associated with the cardiovascular risk profile [J]? Am J Hypertens, 2013 Sep 23.[Epub ahead of print].
15
Amar J,Vernier I, Rossignol E,et al. Nocturnal blood pressure and 24-hour pulse pressure are potent indicators of mortality in hemodialysis patients [J]. Kidney Int,2000,57(6):2485-2491.
16
Liu M, Takahashi H, Moriua Y, et al. Non-dipping is a potent predictor of cardiovascular mortality and is associated with autonomic dysfunction in haemodialysis patients [J]. Nephrol Dial Transplant,2003,18(3):563-569.
17
Wang C,Zhang J,Liu X,et al. Reversed dipper blood-pressure pattern is closely related to severe renal and cardiovascular damage in patients with chronic kidney disease [J]. PLoS One,2013,8(2):e55419.
18
Tonbul Z, Altintepe L, Sözlü C, et al. Ambulatory blood pressure monitoring in haemodialysis and continuous ambulatory peritoneal dialysis(CAPD) patients [J]. J Hum Hypertens,2002,16(8):585-589.
19
Kanbay M, Turgut F, Uyar ME, et al. Causes and mechanisms of nondipping hypertension [J]. Clin Exp Hypertens, 2008, 30(7):585-597.
20
Firsov D, Bonny O. Olivier Bonny. Circadian regulation of renal function [J]. Kidney Int,2010,78(7):640-645.
21
Bonny O, Firsov D. Circadian regulation of renal function and potential role in hypertension [J]. Curr Opin Nephrol Hypertens,2013,22(4):439-444.
22
Mahabala C, Kamath P, Bhaskaran U, et al. Antihypertensive therapy: nocturnal dippers and nondippers. Do we treat them differently [J]? Vasc Health Risk Manag,2013,9:125-133.
23
Hermida RC, Ayala DE, Mojón A, et al. Bedtime dosing of antihypertensive medications reduces cardiovascular risk in CKD[J]. J Am Soc Nephrol,2011,22(12):2313-2321.
24
Yanagi M, Tamura K, Fujikawa T, et al. The angiotensin Ⅱtype 1 receptor blocker olmesartan preferentially improves nocturnal hypertension and proteinuria in chronic kidney disease [ J].Hypertens Res,2013,36(3):262-269.
25
Minutolo R, Gabbai FB, Borrelli S, et al. Changing the timing of antihypertensive therapy to reduce nocturnal blood pressure in CKD:an 8-week uncontrolled trial [J]. Am J Kidney Dis,2007,50(6):908-917.
26
Hermida RC, Ayala DE, Smolensky MH, et al. Chronotherapy improves blood pressure control and reduces vascular risk in CKD[J]. Nat Rev Nephrol,2013,9(6):358-368.
27
Crespo JJ,Piñeiro L,Otero A,et al. Administration-time-dependent effects of hypertension treatment on ambulatory blood pressure in patients with chronic kidney disease [J]. Chronobiol Int,2013,30(1-2):159-175.
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