| Literature DB >> 28222633 |
Feng Wang1, Hualing Zhao2, Chao Yang3, Guilan Kong4, Lu Song2, Chunhui Li2, Yiming Wang2, Shuohua Chen5, Jing Wang4, Shouling Wu5.
Abstract
Objective Toexplore the correlation between blood pressure in the supine position and target organ damage in subjects over 60 years of age. Methods In 2444 individuals, we investigated the association of systolic blood pressure (SBP) in the supine position with the target organ damage indices microalbuminuria (ALBU), brachial-ankle pulse wave velocity (baPWV), and carotid intima-media thickness (IMT). Supine hypertension (SH) is defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Subjects were assigned to either the SH group (1275 cases) or the non-SH group (1169 cases). Results The levels of ALBU, baPWV, and IMT, as well as the percentage of participants with ALBU > 30 mg/L, baPWV ≥ 1400 cm/s, and IMT ≥ 1 mm, were significantly higher in the SH group than in the non-SH group. Multivariate logistic regression analysis showed that SH was an independent risk factor for baPWV and IMT, but the relationship with ALBU was not statistically significant after correction for confounding factors. Conclusions SH is a risk factor for target organ damage, as expressed by the indices baPWV and IMT. The association of SH with kidney damage requires further study.Entities:
Keywords: Aged; arteriosclerosis; chronic; hypertension; renal insufficiency; supine position
Mesh:
Year: 2016 PMID: 28222633 PMCID: PMC5536603 DOI: 10.1177/0300060516677175
Source DB: PubMed Journal: J Int Med Res ISSN: 0300-0605 Impact factor: 1.671
General participant data.
| Variable | Total population ( | Non-SH ( | SH ( |
|
|---|---|---|---|---|
| Males (%) | 1656 (67.8) | 755 (64.6) | 901 (70.7) | <0.01 |
| Age (years) | 67.40 ± 6.04 | 66.72 ± 5.97 | 68.03 ± 6.04 | <0.01 |
| Sitting SBP (mmHg) | 143.49 ± 20.93 | 129.15 ± 13.79 | 156.63 ± 17.44 | <0.01 |
| Sitting DBP (mmHg) | 84.52 ± 11.27 | 78.95 ± 8.43 | 89.64 ± 11.13 | <0.01 |
| Supine SBP (mmHg) | 138.95 ± 20.31 | 122.83 ± 10.51 | 153.73 ± 15.26 | <0.01 |
| Supine DBP (mmHg) | 80.41 ± 10.88 | 74.25 ± 7.45 | 86.05 ± 10.48 | <0.01 |
| Supine heart rate (beats/minute) | 74.14 ± 11.56 | 72.57 ± 10.92 | 75.58 ± 11.94 | <0.01 |
| BMI (kg/m2) | 25.35 ± 3.39 | 24.72 ± 3.18 | 25.93 ± 3.47 | <0.01 |
| FBG (mL/L) | 5.89 ± 1.66 | 5.74 ± 1.44 | 6.03 ± 1.83 | <0.01 |
| Lg TG | 0.30 ± 0.54 | 0.26 ± 0.54 | 0.34 ± 0.54 | <0.01 |
| Lg hsCRP | 0.29 ± 1.05 | 0.24 ± 1.06 | 0.34 ± 1.03 | 0.04 |
| LDL-C (mmol/L) | 2.28 ± 0.84 | 2.79 ± 0.74 | 2.89 ± 0.91 | 0.01 |
| Smokers (%) | 536 (21.9) | 256 (21.9) | 280 (22.0) | 0.97 |
| Drinkers (%) | 454 (18.6) | 198 (16.9) | 256 (20.1) | 0.04 |
| Exercising (%) | 1388 (56.8) | 664 (56.8) | 724 (56.8) | 0.99 |
| Antihypertensive medications (%) | 544 (22.3) | 169 (14.5) | 375 (29.4) | <0.01 |
Abbreviations: BMI, body mass index; DBP, diastolic blood pressure; FBG, fasting blood glucose; LDL-C, low-density lipoprotein cholesterol; Lg hsCRP, log-converted hypersensitive C-reactive protein; LgTG, log-converted triglycerides; SBP, systolic blood pressure; SH, supine hypertension. 1 mmHg = 0.133 kPa.
Target organ damage indices of participants.
| Variable | Total population ( | Non-SH ( | SH ( |
|
|---|---|---|---|---|
| ALBU (mg/L) | 28.30 ± 51.54 ( | 24.31 ± 43.31 ( | 33.19 ± 59.91 ( | <0.01 |
| ALBU > 30 (mg/L) | 383 (18.7) | 150 (14.9) | 233 (22.5) | <0.01 |
| baPWV (cm/s) | 1795.95 ± 396.67 ( | 1632.66 ± 310.95 ( | 1934.95 ± 408.76 ( | <0.01 |
| baPWV ≥ 1400 cm/s | 1540 (88.4) | 633 (79.0) | 907 (96.4) | <0.01 |
| IMT (mm) | 0.92 ± 0.18 ( | 0.89 ± 0.16 ( | 0.94 ± 0.19 ( | <0.01 |
| IMT ≥ 1 mm | 791 (35.6) | 317 (29.8) | 474 (41.0) | <0.01 |
Abbreviations: ALBU, microalbuminuria; baPWV, brachial–ankle pulse wave velocity; IMT, carotid intima–media thickness; SH, supine hypertension.
Correlation analysis between different target organ indices and other variables.
| Variable | ALBU ( | baPWV ( | IMT ( | |||
|---|---|---|---|---|---|---|
| r |
| r |
| r |
| |
| Age | 0.04 | 0.07 | 0.32 | <0.01 | 0.18 | <0.01 |
| Sex | −0.01 | 0.78 | 0.01 | 0.73 | −0.15 | <0.01 |
| Supine SBP | 0.14 | <0.01 | 0.49 | <0.01 | 0.16 | <0.01 |
| Sitting SBP | 0.13 | <0.01 | 0.25 | <0.01 | 0.18 | <0.01 |
| Supine heart rate | 0.11 | <0.01 | 0.23 | <0.01 | 0.02 | 0.03 |
| BMI | 0.10 | <0.01 | −0.01 | 0.75 | 0.06 | 0.06 |
| FBG | 0.16 | <0.01 | 0.14 | <0.01 | 0.01 | 0.65 |
| TG | 0.04 | 0.10 | 0.08 | 0.79 | 0.01 | 0.79 |
| hsCRP | 0.11 | <0.01 | 0.01 | 0.98 | 0.06 | 0.02 |
| LDL-C | 0.01 | 0.58 | −0.01 | 0.98 | 0.03 | 0.21 |
| Smoking | 0.01 | 0.71 | −0.08 | <0.01 | 0.06 | 0.01 |
| Drinking | 0.01 | 0.82 | −0.03 | 0.23 | 0.03 | 0.13 |
| Exercising | −0.05 | 0.04 | −0.03 | 0.16 | −0.04 | 0.04 |
| Antihypertensive medications | 0.07 | <0.01 | 0.20 | <0.01 | −0.07 | <0.01 |
Abbreviations: ALBU, microalbuminuria; baPWV, brachial-ankle pulse wave velocity; BMI, body mass index; FBG, fasting blood glucose; hsCRP, hypersensitive C-reactive protein; IMT, carotid intima–media thickness; LDL-C, low-density lipoprotein cholesterol; SBP, systolic blood pressure; TG, triglycerides.
Multivariate logistic regression analysis of factors influencing target organ damage indices.
| Variable | Model 1 | Model 2 | Model 3 | |||
|---|---|---|---|---|---|---|
| OR (95%CI) |
| OR (95%CI) |
| OR (95%CI) |
| |
| ALBU (mg/L) | 1.66 (1.33–2.08) | <0.01 | 1.61 (1.28–2.03) | <0.01 | 1.34 (0.99–1.82) | 0.06 |
| baPWV (cm/s) | 7.08 (4.83–10.4) | <0.01 | 6.76 (4.58–10.0) | <0.01 | 5.15 (3.43–7.73) | <0.01 |
| IMT (mm) | 1.64 (1.37–1.95) | <0.01 | 1.51 (1.25–1.81) | <0.01 | 1.47 (1.17–1.87) | <0.01 |
Abbreviations: ALBU, microalbuminuria; baPWV, brachial–ankle pulse wave velocity; BMI, body mass index; CI, confidence interval; FBG, fasting blood glucose; hsCRP, hypersensitive C-reactive protein; IMT, carotid artery intima–media thickness; LDL-C, low-density lipoprotein cholesterol; OR, odds ratio; SBP, systolic blood pressure; SH, supine hypertension.
Model 1 assumed ALBU (<30 mg/L assigned 0, ≥ 30 mg/L assigned 1), baPWV (<1400 cm/s assigned 0, ≥ 1400 cm/s assigned 1), and IMT(<1. 00 mm assigned 0, ≥ 1. 00 mm assigned 1) as dependent variables, and SH (Yes/No) as the independent variable. Univariate regression analysis was carried out. Model 2 was based on Model 1, with correction for age and sex. Model 3 was based on Model 2, with correction for sitting SBP (<140 mmHg assigned 0, ≥ 140 mmHg assigned 1), sitting DBP (<90 mmHg assigned 0, ≥ 90 mmHg assigned 1), BMI (<24 kg/m2 assigned 0, ≥ 24 kg/m2 assigned 1), FBG (<6.1 mmol/L assigned 0, ≥ 6.1 mmol/L assigned 1), LDL-C (≤3.64 mmol/L assigned 0, > 3.64 mmol/L assigned 1), hsCRP (<2 mg/L assigned 0, ≥ 2 mg/L assigned 1), smoking (No/Yes), alcohol consumption (No/Yes), exercise (No/Yes), and use of antihypertensive medication (No/Yes).