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已发表论文
动态动脉压指数与原发性高血压合并冠心病患者昼夜血压模式的关联
Authors Tang Y, Yang L, Zhang M, Wang L
Received 1 September 2025
Accepted for publication 4 December 2025
Published 20 January 2026 Volume 2026:19 558332
DOI https://doi.org/10.2147/IJGM.S558332
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Redoy Ranjan
Yuanyuan Tang, Lingfei Yang, Mingchao Zhang, Lei Wang
Department of Cardiovascular Medicine, The Second Affiliated Hospital of Wannan Medical College, Wuhu City, Anhui Province, 241000, People’s Republic of China
Correspondence: Yuanyuan Tang, Department of Cardiovascular Medicine, The Second Affiliated Hospital of Wannan Medical College, No. 10, KangFu Road, Jinghu District, Wuhu City, Anhui Province, 241000, People’s Republic of China, Email YuanyuanTang3@163.com
Background: Disruption of circadian blood pressure (BP) rhythms—manifested as non-dipper or reverse-dipper patterns—is associated with increased cardiovascular risk, especially in patients with primary hypertension (PH) and concomitant coronary artery disease (CAD). The ambulatory arterial pressure index (AAPI), a novel parameter derived from 24-hour ambulatory BP monitoring (ABPM), reflects the cumulative hemodynamic burden and may provide insight into circadian BP abnormalities. However, its relationship with BP rhythm patterns in this high-risk population remains unclear.
Methods: This retrospective observational study included 430 hospitalized patients with PH and CAD who underwent 24-hour ABPM between January 2022 and December 2023. Patients were classified into dipper (n = 51), non-dipper (n = 266), and reverse-dipper (n = 113) groups based on the nocturnal decline in systolic BP. AAPI was calculated as the ratio of diastolic to systolic pressure load over a 24-hour period. Baseline demographic, biochemical, and hemodynamic variables were compared across groups, and correlations between AAPI and BP rhythm categories were analyzed.
Results: The mean age was 69.1 ± 17.8 years, and 63.5% of patients were male. There were no significant differences in age, sex, renal function, or lipid profiles across circadian BP rhythm subgroups. Patients with disrupted BP rhythms (non-dipper or reverse-dipper) had significantly higher AAPI values than those with a dipper pattern (0.396 ± 0.041 vs 0.387 ± 0.043, p = 0.022). AAPI values showed a significant positive correlation with rhythm severity (r = 0.18, p = 0.004).
Conclusion: AAPI is significantly associated with abnormal circadian BP patterns in patients with PH and CAD. As a simple, integrative hemodynamic index, AAPI may aid in the early identification of patients with rhythm disruption and provide added value for personalized cardiovascular risk stratification.
Keywords: ambulatory arterial pressure index, circadian blood pressure rhythm, primary hypertension, coronary artery disease, ambulatory blood pressure monitoring
Department of Cardiovascular Medicine, The Second Affiliated Hospital of Wannan Medical College, Wuhu City, Anhui Province, 241000, People’s Republic of China
Correspondence: Yuanyuan Tang, Department of Cardiovascular Medicine, The Second Affiliated Hospital of Wannan Medical College, No. 10, KangFu Road, Jinghu District, Wuhu City, Anhui Province, 241000, People’s Republic of China, Email YuanyuanTang3@163.com
Background: Disruption of circadian blood pressure (BP) rhythms—manifested as non-dipper or reverse-dipper patterns—is associated with increased cardiovascular risk, especially in patients with primary hypertension (PH) and concomitant coronary artery disease (CAD). The ambulatory arterial pressure index (AAPI), a novel parameter derived from 24-hour ambulatory BP monitoring (ABPM), reflects the cumulative hemodynamic burden and may provide insight into circadian BP abnormalities. However, its relationship with BP rhythm patterns in this high-risk population remains unclear.
Methods: This retrospective observational study included 430 hospitalized patients with PH and CAD who underwent 24-hour ABPM between January 2022 and December 2023. Patients were classified into dipper (n = 51), non-dipper (n = 266), and reverse-dipper (n = 113) groups based on the nocturnal decline in systolic BP. AAPI was calculated as the ratio of diastolic to systolic pressure load over a 24-hour period. Baseline demographic, biochemical, and hemodynamic variables were compared across groups, and correlations between AAPI and BP rhythm categories were analyzed.
Results: The mean age was 69.1 ± 17.8 years, and 63.5% of patients were male. There were no significant differences in age, sex, renal function, or lipid profiles across circadian BP rhythm subgroups. Patients with disrupted BP rhythms (non-dipper or reverse-dipper) had significantly higher AAPI values than those with a dipper pattern (0.396 ± 0.041 vs 0.387 ± 0.043, p = 0.022). AAPI values showed a significant positive correlation with rhythm severity (r = 0.18, p = 0.004).
Conclusion: AAPI is significantly associated with abnormal circadian BP patterns in patients with PH and CAD. As a simple, integrative hemodynamic index, AAPI may aid in the early identification of patients with rhythm disruption and provide added value for personalized cardiovascular risk stratification.
Keywords: ambulatory arterial pressure index, circadian blood pressure rhythm, primary hypertension, coronary artery disease, ambulatory blood pressure monitoring