The Analysis Of The Relationship Between Nocturnal Hypertension And Some Related Factors

Objective: To investigate the relationship between nocturnal high blood pressure andplasma rennin activity (PRA), angiotensin, aldosterone(ALD), cortisol(Cor), clockgene Per2and Per3gene polymorphism, sleep disorders, left ventricular hypertrophy(LVH) in patients with essential hypertension, so as to prevent and treat nocturnalhypertension specifically.Method: The188cases were enrolled from those who attended to department ofcardiology outpatient and hospital for care in FuJian Provincial Hospital duringSeptember2011to February2013,continuously. According to ambulatory bloodpressure monitoring(ABPM),all case were divided into two groups, the nocturnalhypertension group (n=134) and non-nocturnal hypertension group (n=54). Recordthe clinical data and detect relevant biochemical markers. The Per2and Per3genepolymorphism were genotyped with polymerase chain reaction and restrictionfragment length polymorphism (PCR-RFLP) and verified by direct sequencing of thegene.Results:1.The genotype frequencies of per2and per3were conformed to the Hardy-Weinbergequilibrium (p>0.05).2. Compared with control group,the d DBP, n SBP, n DBP,24h SBP,24h DBP weresignificant higher in nocturnal hypertension (p<0.05)，conversely，were no significantdifference in sex, age, height, weight, waist circumference, BMI, TC, TG, PG, HDL,LDL, Na+,K+,Ca2+,Cr,Ccr (p>0.05).3. The A and G allele frequencies of per2were no significant difference in nocturnalhypertension group and control group(0.678,0.648and0.322,0.352respectively,p>0.05). Participants with the4or5variable tandem repeat sequence of per3were nosignificant difference in nocturnal hypertension group and control group(0.851,0.935and0.149,0.065respectively, p>0.05).4. In the univariate analysis, compared with non-nocturnal hypertension group, the nocturnal hypertension group were significant higher in PRA, AngiotensinⅠ(AngⅠ),AngiotensinⅡ(AngⅡ), ALD, Cor.5. In the univariate analysis,the percentage of dyssomnia in nocturnal hypertensionwas higher than control group (37.3%,22.2%respectively, p<0.05). The risk ofdyssomnia patients causing to nocturnal hypertension was2.083times of the patientswithout dyssomnia. In addition, the polymorphism and allele frequency of Per3genewere significantly different in the dyssomnia group and control group(p <0.05).6. Compared with non-nocturnal hypertension group,The percentage of leftventricular hypertrophy (LVH) in nocturnal hypertension was significant higher thannon-nocturnal hypertension (85.7%vs68.0%, p<0.05). The risk of LVH in nocturnalhypertension was2.827times of non-nocturnal hypertension.7. In the multivariate analysis,individ the participants by median of PRA, AngⅠ, AngⅡ, ALD, Cor to the low and high value group. Adjust the multivariable confoundingfactors by using a logistic regression analysis,the high value group of AngⅡanddyssomnia had a significant association with nocturnal hypertension(p<0.05),meanmhile, had a higher risk of3.196and2.271times than the low valuegroup, respectively.Conclusions:The study found nocturnal hypertension might be related to dyssomnia. Thepolymorphism of Per2and Per3gene were no significant difference between thenocturnal hypertension and the control group,conversely in the the dyssomnia andcontrol group.The renin-angiotensn-aldosterone system (RAAS) may be plays animportant role in nocturnal hypertension. In addition,nocturnal hypertension wasassociated with LVH.