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The relationship between proteinuria and ambulatory blood pressure in hypertensive patients

Beyza Algül Durak1, Musa İlker Durak2, Alper Özbakkaloğlu3

1Department of Nephrology, Ankara Bilkent City Hospital, Ankara, Türkiye
2Department of Cardiology, Ankara Etlik City Hospital, Ankara, Türkiye
3Department of Cardiovascular Surgery, Private Health Hospital, İzmir, Türkiye

Keywords: Ambulatory blood pressure monitoring, hypertension, proteinuria
Objectives: The study aimed to investigate the relationship between proteinuria and blood pressure (BP) determined with ambulatory BP monitoring (ABPM) in patients who applied to the nephrology clinic due to hypertension.

Patients and methods: A total of 163 patients (84 males, 79 females; mean age: 55.7±16.6 years; range, 18 to 80 years) were included in the cross-sectional study between January 2022 and January 2023. The amount of proteinuria was measured from 24-h urine samples. The ABPM values were measured using noninvasive multitasking BP recorders.

Results: A total of 53.4% (n=87) of the patients had dipper, 29.4% (n=48) had non-dipper, and 17.2% (n=28) had reverse-dipper hypertension (HT). Dipper HT, albumin, and glomerular filtration rate were significantly lower in those with proteinuria compared to those without proteinuria. Age, creatinine, HT duration, 24-h, daytime, and nighttime systolic BP, nighttime diastolic BP, nighttime mean BP, non-dipper HT (all p<0.001), 24-h diastolic BP (p=0.015), daytime mean BP (p=0.005), and reverse-dipper HT (p=0.001) were significantly higher in the group with proteinuria.

Conclusion: Elevated ABPM values, non-dipper HT, and reverse-dipper HT were detected in patients who had high proteinuria. Creatinine and 24-h urine protein excretion were found to be higher in patients with non-dipper HT and reverse-dipper HT. The progression of proteinuria can be slowed down by strict BP control in hypertensive patients with proteinuria.

DOI : 10.5606/e-cvsi.2025.1775