Changes Of Blood Pressure Rhythm In Patients With Primary Aldosteronism

Objective:To investigate the changes of blood pressure rhythm in patients with primary aldosteronism(PA).Methods:We continuously included 129 patients diagnosed with PA in the Second Affiliated Hospital of Nanchang University from October 2017 to November 2019,and used SPSS 21.0 software to perform a propensity score from the EH patient database of the Second Affiliated Hospital of Nanchang University with 4 factors including gender,age,24-hour average systolic blood pressure and 24-hour average diastolic blood pressure.A total of 129 EH patients were selected as the case control group.The baseline data of the two groups,including 24-hour ambulatory blood pressure monitoring(ABPM),such as the number of antihypertensive drugs and morning medication,were collected and statistically analyzed.The differences of blood pressure rhythm between PA and EH patients were compared.Results:(1)There were no significant differences in the number of antihypertensive drugs,the use of morning medication,usage rate of calcium channel blockers and beta blockers in the two groups of EH and PA(P>0.05);The proportion of combined use of drugs(? 2)was lower and the proportion of the use of ?-blockers and bedtime medication was higher in PA group.(2)There was no significant difference in the ratio of dipper/non-dipper blood pressure and the average level of SBP and DBP at night between PA group and EH group(P>0.05).(3)The incidence of morning hypertension was 84.50% in PA patients and 71.32% in EH patients.The incidence of morning hypertension in PA group was significantly higher than that in EH group(P <0.05).(4)Compared with the EH group,the interventricular septum thickness(IVST)and left ventricular mass index(LVMI)in the PA group were significantly increased(P <0.05).(5)Univariate logistic regression analysis found that PA(OR = 2.192,95% CI: 1.190,4.037,P = 0.012),male gender(OR = 2.262,95% CI: 1.243,4.113,P = 0.007),and serum uric acid(OR = 1.004,95% CI: 1.001,1.007,P = 0.019)levels were significantly correlated with morning hypertension;further multivariate logistic regression found that PA was independently and significantly correlated with morning hypertension(OR = 2.458,95% CI : 1.306,4.624,P = 0.005).Conclusion:(1)Compared with adult EH patients,the proportion of morning hypertensionin adult PA patients was significantly increased,but there was no significantdifference between the proportion of dipper/non-dipper blood pressure andthe average level of SBP and DBP at night.(2)PA is an independent risk factor for morning hypertension in adults withhypertension.