Relationship of 24-hour urinary protein and blood pressure variability with sleep disorders in patients with essential hypertension

doi:10.3877/cma.j.issn.1674-0785.2023.01.008

Abstract

Abstract:

Objective

To analyze the relationship of 24-hour urinary protein quantification (24 h-UTP) and blood pressure variability (BPV) with sleep disorders in patients with essential hypertension (EHT).

Methods

A total of 200 patients with EHT who were treated at Yulin First People's Hospital from June 2017 to December 2019 were selected as the research subjects. All patients received antihypertensive treatment for 1 month. Before treatment, 24 h-UTP was detected, blood pressure was measured, and blood pressure variation coefficients [coefficient of variation of systolic blood pressure (SCV) and coefficient of variation of diastolic blood pressure (DCV)] were calculated. After 1 month of treatment, the Pittsburgh sleep quality index (PSQI) scale was used to evaluate sleep quality, and the patients were grouped based on the sleep quality. The relationship of 24 h-UTP and blood pressure variation coefficients with sleep disorders in EHT patients was analyzed.

Results

The 24 h-UTP of EHT patients was 44.01 (42.41, 45.50) mg/24 h before the treatment, the SCV was 11.53 (10.87, 12.22), and the DCV was 7.75 (7.38,8.10). The PSQI score of the patients after 1 month of treatment was 6.50 (3.00,7.00) points. The results of correlation analysis showed that there was a negative correlation between 24 h-UTP and PSQI score (r=-0.763, P＜0.05). There was a positive correlation between SCV and DCV and PSQI score (r=0.815 and 0.759, respectively, P＜0.05). After one month of treatment, 49 of the 200 patients (24.50%) had sleep disorders. The results of regression analysis showed that high SCV (OR=1.580, P=0.021), DCV (OR=1.592, P＜0.001), and 24 h-UTP (OR=1.403, P＜0.001) might be risk factors for sleep disorders in EHT patients after treatment. The receiver operator characteristic (ROC) curve was drawn and the results showed that the area under the curve (AUC) values of SCV, DCV, and 24 h-UTP in predicting the risk of sleep disorders in EHT patients after treatment was 0.822 (95%CI: 0.757-0.888), 0.856 (95%CI: 0.783-0.928), and 0.863 (95%CI: 0.787-0.938), respectively, and the predictive value was satisfactory.

Conclusion

24 h-UTP and BPV are related to the sleep quality in patients with EHT, which may be risk factors for sleep disorders in the patients after treatment, and they have appreciated value in predicting the risk of sleep disorders in patients after treatment.

Key words: Essential hypertension, 24-hour urinary protein quantification, Blood pressure variability, Sleep disorder, Correlation

Shuyi Zeng, Xiangwen Liang, Zhihai Lin, Yiyi Li, Zheng Ling, Zhengdong Wang. Relationship of 24-hour urinary protein and blood pressure variability with sleep disorders in patients with essential hypertension[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(01): 48-53.

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References 20

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项目	24 h-UTP	SCV	DCV	PSQI评分
24 h-UTP	-	r=-0.751^a，P＜0.001	r=-0.731^a，P＜0.001	r=-0.763^a，P＜0.001
SCV	r=-0.751^a，P＜0.001	-	r=0.789^a，P＜0.001	r=0.815^a，P＜0.001
DCV	r=-0.731^a，P＜0.001	r=0.789^a，P＜0.001	-	r=0.759^a，P＜0.001
PSQI评分	r=-0.763^a，P＜0.001	r=0.815^a，P＜0.001	r=0.759^a，P＜0.001	-

项目	24 h-UTP	SCV	DCV	PSQI评分
24 h-UTP	-	r=-0.751^a，P＜0.001	r=-0.731^a，P＜0.001	r=-0.763^a，P＜0.001
SCV	r=-0.751^a，P＜0.001	-	r=0.789^a，P＜0.001	r=0.815^a，P＜0.001
DCV	r=-0.731^a，P＜0.001	r=0.789^a，P＜0.001	-	r=0.759^a，P＜0.001
PSQI评分	r=-0.763^a，P＜0.001	r=0.815^a，P＜0.001	r=0.759^a，P＜0.001	-

项目	睡眠障碍组（n=49）	睡眠良好组（n=151）	U/χ²值	P值
年龄（岁）	64.00（63.00，66.00）	64.00（62.00，65.00）	1.391	0.164
性别（男/女）	29/20	78/73	0.843	0.359
吸烟史（有/无）	26/23	75/76	0.170	0.680
EHT病程（年）	3.00（3.00，4.00）	3.00（2.00，3.00）	1.885	0.059
HbA1c（%）	13.82（13.11，15.16）	13.95（13.23，14.93）	0.119	0.905
TG（mmol/L）	2.42（2.33，2.53）	2.42（2.33，2.51）	0.119	0.905
TC（mmol/L）	4.64（4.49，4.72）	4.60（4.45，4.74）	0.502	0.616
HDL-C（mmol/L）	1.00（0.98，1.03）	1.00（0.98，1.02）	0.156	0.876
LDL-C（mmol/L）	2.68（2.65，2.73）	2.68（2.65，2.72）	0.204	0.839
CRP（μg/L）	920.57（860.66，970.19）	904.27（868.25，977.49）	0.149	0.881
PCT（ug/L）	0.67（0.64，0.70）	0.66（0.64，0.70）	0.766	0.444
SCV	16.51（16.00，17.49）	15.13（14.31，16.00）	6.774	＜0.001
DCV	12.69（11.56，13.52）	9.88（8.75，10.82）	7.474	＜0.001
24 h-UTP（mg/24 h）	25.72（25.04，26.65）	24.51（24.28，24.78）	7.620	＜0.001

项目	睡眠障碍组（n=49）	睡眠良好组（n=151）	U/χ²值	P值
年龄（岁）	64.00（63.00，66.00）	64.00（62.00，65.00）	1.391	0.164
性别（男/女）	29/20	78/73	0.843	0.359
吸烟史（有/无）	26/23	75/76	0.170	0.680
EHT病程（年）	3.00（3.00，4.00）	3.00（2.00，3.00）	1.885	0.059
HbA1c（%）	13.82（13.11，15.16）	13.95（13.23，14.93）	0.119	0.905
TG（mmol/L）	2.42（2.33，2.53）	2.42（2.33，2.51）	0.119	0.905
TC（mmol/L）	4.64（4.49，4.72）	4.60（4.45，4.74）	0.502	0.616
HDL-C（mmol/L）	1.00（0.98，1.03）	1.00（0.98，1.02）	0.156	0.876
LDL-C（mmol/L）	2.68（2.65，2.73）	2.68（2.65，2.72）	0.204	0.839
CRP（μg/L）	920.57（860.66，970.19）	904.27（868.25，977.49）	0.149	0.881
PCT（ug/L）	0.67（0.64，0.70）	0.66（0.64，0.70）	0.766	0.444
SCV	16.51（16.00，17.49）	15.13（14.31，16.00）	6.774	＜0.001
DCV	12.69（11.56，13.52）	9.88（8.75，10.82）	7.474	＜0.001
24 h-UTP（mg/24 h）	25.72（25.04，26.65）	24.51（24.28，24.78）	7.620	＜0.001

项目	B	S.E	Wals	P值	OR值	95%CI
常量	1.128	0.674	41.556	＜0.001	1.214	-
SCV	1.544	0.236	5.326	0.021	1.580	1.365~1.921
DCV	1.524	1.149	12.397	＜0.001	1.592	1.443~1.793
24 h-UTP	1.310	0.200	20.722	＜0.001	1.403	1.272~1.596

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