The Relationship Between Uric Acid And Nondipping Circadian Pattern In Patients With Essential Hypertension

Objectives To investigate the relationship between uric acid and the circadian bloodpressure rhythm in patients with essential hypertension.Methods129inpatients and outpatients who were newly diagnosed essentialhypertension were collected in our hospital (Fujian Medical University AffiliatedQuanzhou First Hospital) from January2012to January2013, Of which73cases ofmale,56cases of female, aged47to77years old, mean age (62.50±7.63) years old.The hypertensive patients were divided into dipper group (n=68) and non-dippertype group (n=61) according to the result of24-hour ambulatory blood pressuremonitoring (ABPM). All patients were measured the biochemical indicators includingliver function, renal function, serum lipids, fasting blood glucose, serum uric acid andhigh-sensitivity C-reactive protein. Compared the two groups with general data,laboratory tests and ambulatory blood pressure parameters and analyzed therelationship with correlation analysis and unconditional logistic regression analysis.Results1.There was no significant difference(P>0.05) between the two groups ingender, age, smoking, family history of hypertension, body mass index, serum lipids,fasting blood glucose, serum creatinine, urea nitrogen, total bilirubin and casual bloodpressure. Compared with dipper group, the levels of HS-CRP and uric acid weresignificantly higher in non-dipper group(P<0.01).2.There was no significant difference(P>0.05) between the two groups indaytime mean systolic and diastolic blood pressure. Compared with dipper group,nightime mean systolic and diastolic blood pressure(P<0.01),24-hour mean systolicblood pressure(P<0.01) and diastolic blood pressure(P<0.05) were significantlyhigher in non-dipper group; the rates of decline in nocturnal systolic and diastolicblood pressure were significantly lower in non-dipper group(P<0.01).3. Serum uric acid was negatively correlated with the rates of decline innocturnal systolic and diastolic blood pressure(r=-0.716，P<0.001；r=-0.772，P<0.001)in dipper group. Serum uric acid was negatively correlated with the rates of decline innocturnal systolic and diastolic blood pressure(r=-0.813，P<0.001；r=-0.715，P<0.001)in non-dipper group.Serum uric acid was positively correlated with HS-CRP(r=0.354，P=0.002).4.The logistic regression analysis showed that serum uric acid(OR=3.258，95%CI:2.126-4.984，P=0.016) and HS-CRP(OR=1.936，95%CI:1.327-2.823，P=0.037)had independent relationship with nondipping circadian pattern.Conclusions Serum uric acid and HS-CRP have independent relationship withnondipping circadian pattern in patients with essential hypertension. Serum uric aicdmay affect nondipping circadian pattern by its proinflammatory effect.