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Study on the ambulatory blood pressure phenotype and its correlation with hemoglobin concentration in untreated hypertensive individuals permanently living in plateau areas

Hypertension Research (2025)Cite this article

Abstract

Ambulatory blood pressure monitoring (ABPM) studies for high altitude (HA) hypertensive patients are limited. We aimed to explore the hypertension phenotypes, and investigate their associations with hemoglobin in untreated hypertensives permanently living in HA. A total of 342 untreated hypertensive patients were included. Among the whole population, 91.80% had sustained hypertension (SH). In patients with SH, the proportions of isolated daytime hypertension, isolated nocturnal hypertension, and day-night hypertension were 2.87%, 2.87%, and 94.26%, respectively. Compared to patients with hemoglobin ≥16 g/dL, those with hemoglobin <16 g/dL had higher nocturnal average systolic blood pressure (SBP) (140.33 ± 17.46 vs. 136.26 ± 17.55 mmHg, P = 0.03) and a greater proportion of patients with nocturnal SBP fall<10% (55.00% vs. 43.30%, P = 0.03). Bivariate correlation analysis showed that hemoglobin was negatively correlated with the nocturnal average SBP (r = −0.145, P < 0.01) and was positively related to the nocturnal SBP fall (r = 0.136, P = 0.01). We found that the threshold effect value between hemoglobin and nocturnal blood pressure indices was 16 g/dL. The effect value between hemoglobin and nocturnal average SBP was −3.60 (−5.46, −1.74) for hemoglobin <16 g/dL and 0.88 (−1.07, 2.83) for hemoglobin ≥16 g/dL. Correspondingly, the effect values between hemoglobin and nocturnal SBP fall were 1.53 (0.61, 2.45) and −0.26 (−1.23, 0.70). In addition, hemoglobin was independently correlated with the above-mentioned nocturnal blood pressure indices in those with hemoglobin <16 g/dL. In conclusion, nocturnal hypertension was a prevalent ABPM phenotype in HA hypertensive patients. In those with hemoglobin levels <16 g/dL, hemoglobin concentration shows a significant inverse correlation with nocturnal SBP, suggesting that lower hemoglobin levels may warrant enhanced evaluation of nocturnal BP in this population.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors sincerely thank the doctors, nurses, and medical laboratory staffs from the Jiulong, Luhuo, and Litang County People’s hospitals for their kind help in data collection. Second, we thank all participants who were enrolled in this investigation.

Funding

This manuscript was funded by the Science and Technology Program of Tibet Autonomous Region (Grant number: XZ202303ZY0004G) and the Sichuan Natural Science Foundation project (Grant number: 2022NSFSC0801 and 2023NSFSC1632).

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  1. These authors contributed equally: Xin Zhang, Runyu Ye

Authors and Affiliations

  1. Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China

    Xin Zhang, Runyu Ye, Xiangyu Yang, Xinran Li, Zhipeng Zhang, Qingtao Meng & Xiaoping Chen

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Contributions

Study design: Xin Zhang, Xiaoping Chen. Data collection: Runyu Ye, Xiangyu Yang, Xinran Li, Zhipeng Zhang. Analysis and interpretation of data: Xin Zhang, Runyu Ye, Xiangyu Yang. Drafting of the manuscript: Xin Zhang, Xiangyu Yang. Correction: Qingtao Meng, Xiaoping Chen. Approval of the final version for publication: all the authors.

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Correspondence to Xiaoping Chen.

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The research protocol was reviewed by the Medical Ethics Committee of West China Hospital, Sichuan University. All procedures performed in studies involving human participants were in accordance with the ethical guidelines of the Declaration of Helsinki. Informed written consent was obtained from patients before enrollment.

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Zhang, X., Ye, R., Yang, X. et al. Study on the ambulatory blood pressure phenotype and its correlation with hemoglobin concentration in untreated hypertensive individuals permanently living in plateau areas. Hypertens Res (2025). https://doi.org/10.1038/s41440-025-02350-5

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