The Clinical Significance of Daytime and Nighttime Blood Pressure Changes in Patients with Renal Parenchymal Hypertension

Objective: To study the clinical significance of daytime and nighttime blood pressure changes in patients diagnosed with renal parenchymal hypertension (RPH). Methods: Subgrouping 50 patients of diagnosed RPH into renal insufficiency compensatory period (RICP) of 20 cases, with an average age of 55±7.88 years old, renal insufficiency decompensated period (RIDP) of 17 cases, with an average age of 56±12.9 years old, renal failure (RF) of 13 cases, with an average age of 53±10.34 years old. Normal group was composed with 30 individuals selected from the healthy people with normal ambulatory blood pressure (ABPM).The Spacelab 90207, a non-invading ambulatory blood pressure monitor, was used to obtain indexes including 24-hour mean systolic blood pressure (24 h SBP), 24-hour mean diastolic blood pressure (24 h DBP), daytime mean systolic blood pressure(dSBP), daytime mean diastolic blood pressure (dDBP), nighttime mean systolic blood pressure (nSBP), nighttime mean diastolic blood pressure (nDBP), nSBP/dSBP, nDBP/dDBP, mean arterial pressure (MAP), systolic blood pressure load, and diastolic blood pressure load. Results: 1. In comparison to the normal group, three subgroups with RPH projected higher values in all indexes. 2. Standard Deviations among these 3 RPH subgroups were obviously different. It was particularly different in systolic and diastolic loads, where the RIDP higher, and RF of 60% higher. 3. The statistical analysis resulted from one-on-one comparison between RPH subgroups showed that SBP, DBP and MAP were significantly different, while other indexes had no statistical differences. Conclusions: The rhythms of day and night changes of blood pressure in RPH sufferings disappeared. The values of blood pressure load and MAP in renal decompensated rise along with the deterioration of renal function. Effective control of blood pressure load and MAP may slow down this deterioration.