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論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Circadian hemodynamic characteristics in hypertensive patients with primary aldosteronism.
掲載誌名	正式名：Journal of hypertension 略　 称：J Hypertens ISSNコード：1473-5598(Electronic)0263-6352(Linking)
掲載区分	国外
巻・号・頁	36(11),pp.2260-8
著者・共著者	Kusunoki Hiroshi, Iwashima Yoshio, Kawano Yuhei, Hayashi Shin-Ichiro, Kishida Masatsugu, Horio Takeshi, Shinmura Ken, Yoshihara Fumiki
発行年月	2018/11
概要	OBJECTIVE:The present study aimed to compare circadian hemodynamic characteristics in hypertensive patients with and without primary aldosteronism.METHODS:Circadian hemodynamics, including 24-h brachial and central blood pressure (BP), SBP variability indices, central pulse wave velocity (PWV), augmentation index (AIx@75), cardiac index, and total vascular resistance (TVR), were evaluated using an oscillometric device, Mobil-O-Graph, in 60 patients with primary aldosteronism (63.4±13.3 years, 47% women) and 120 age-matched and sex-matched patients with essential hypertension.RESULTS:Office SBP, PWV, AIx@75, and BP variability indices were similar between groups; however, 24-h brachial (124 ± 14 vs 130 ± 11 mmHg) as well as central (112 ± 12 vs 120 ± 10 mmHg) SBP was higher (both P < 0.01), and the difference between 24-h brachial and central SBP (11 ± 5 vs 9 ± 3 mmHg, P < 0.05), an index of pressure amplification, was smaller in primary aldosteronism than in essential hypertension. In both groups, cardiac index decreased from daytime to night-time (both P < 0.01), but this decrease was smaller in primary aldosteronism (P < 0.05). During daytime, TVR in primary aldosteronism was higher than that in essential hypertension (P < 0.05), and the significant increase of TVR from daytime to night-time was lost in primary aldosteronism. In a multivariate stepwise regression model, primary aldosteronism emerged as an independent predictor of 24-h central SBP as well as the difference between 24-h brachial and central SBP.CONCLUSION:Our results demonstrated that circadian hemodynamics in primary aldosteronism patients are characterized by increased central SBP, smaller disparity between brachial and central SBP, and disturbed circadian hemodynamic variation.
DOI	10.1097/HJH.0000000000001800
PMID	29846324