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引用次数: 7
摘要
摘要目的:探讨新诊断高血压患者晨起血压(BP)峰值与动脉僵硬度的关系。对象和方法:纳入24小时动态血压监测的新诊断高血压患者324例(平均年龄51.7±11.4岁)。采用压血压计测量动脉硬度、脉搏波速度、增强指数(Aix),超声心动图计算主动脉扩张率。结果:与其他组比较,晨搏高组脉搏波速度、昼夜收缩压(SBP)差值(p < 0.001)和hs-CRP (p = 0.005)均较高。清晨血压升高组主动脉瓣扩张系数显著低于其他组(p < 0.05)。多因素线性回归分析发现,晨间血压升高与脉搏波速(β= 0.286, p < 0.001)、主动脉扩张度(β= - 0.384, p < 0.001)和昼夜收缩压差(β= 0.229, p < 0.001)独立相关。结论:我们发现早晨血压升高与动脉僵硬度之间存在独立关系,动脉僵硬度是心血管疾病的替代终点。本研究发现的晨间血压升高与主动脉瓣扩张呈反比关系,与主动脉瓣扩张有直接关系,这在文献中尚属首次。
Morning blood pressure surge and arterial stiffness in newly diagnosed hypertensive patients
Abstract Objective: We aimed to investigate the relationship between the morning blood pressure (BP) surge and arterial stiffness in patients with newly diagnosed hypertension. Subjects and methods: Three hundred and twenty four (mean age 51.7 ± 11.4 years) patients who had newly diagnosed hypertension with 24 h ambulatory BP monitoring were enrolled. Parameters of arterial stiffness, pulse wave velocity and augmentation index (Aix) were measured by applanation tonometry and aortic distensibility was calculated by echocardiography. Results: Compared with the other groups, pulse wave velocity, day–night systolic BP (SBP) difference (p < 0.001, for all) and hs-CRP (p = 0.005) were higher in morning BP surge high group. Aortic distensibility values were significantly lower in morning BP surge high group compared to the other groups (p < 0.05, for all). Morning BP surge was found to be independently associated with pulse wave velocity (β = 0.286, p < 0.001), aortic distensibility (β= −0.384, p < 0.001) and day–night SBP difference (β = 0.229, p < 0.001) in multivariate linear regression analysis. Conclusions: We found independent relationship between morning BP surge and arterial stiffness which is a surrogate endpoint for cardiovascular diseases. The inverse relationship between morning BP surge and aortic distensibility and direct relation found in our study is new to the literature.
期刊介绍:
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Features include:
• Physiology and pathophysiology of blood pressure regulation
• Primary and secondary hypertension
• Cerebrovascular and cardiovascular complications of hypertension
• Detection, treatment and follow-up of hypertension
• Non pharmacological and pharmacological management
• Large outcome trials in hypertension.