고혈압 환자에서 활동혈압의 근사엔트로피와 아침혈압상승과의 관계

Abstract

highest quartile) of hypertensive patients, odds ratio of high ApEn was 33.86 (95% CI: 6.74 – 169.96, p < 0.001) and 0.56 was odds ratio of antihypertensive medication (95% CI: 0.33 – 0.95, p = 0.030).

Conclusion ApEn of ABP is independently associated with morning surge in hypertensive patients.; Background Approximate entropy (ApEn) of ambulatory blood pressure (ABP) is a statistic that represents the unpredictability of fluctuations in a time series, but the clinical value of this statistic in ABP is not well-known. The morning surge was considered as a physiological phenomenon in the morning. However, it may be associated with target organ damage and cardiovascular risk in hypertensive patients. Therefore, the aim of this study is to define the relation between ApEn of ABP and morning surge.

Subjects and methods Among ambulatory blood pressure monitoring (ABPM) database, data of 435 patients who underwent ABPM and were analyzed retrospectively. ApEn is measured based on software analyzing 24 hour ABPM. Morning surge was quantified as the sleep-trough surge, defined as as the morning systolic BP minus the lowest systolic BP during sleep.

Results 24 hour, daytime, and nighttime systolic BP in hypertensive patients were 137.9 ± 17.2 mmHg, 139.6 ± 22.1 mmHg and 130.8±20.1 mmHg, respectively. ApEn was 3.5 ± 0.3 and morning surge was 33.1 ± 17.8 mmHg. In a multiple linear regression model for morning surge in hypertensive patients, ApEn (β = 30.09, p < 0.001) and antihypertensive medication (β = 5.78, p = 0.002) were independently associated with morning surge. In a multiple logistic regression model for the high morning surge (> 41.4 mmHg