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|本期目录/Table of Contents|

高血压病患者血压晨峰与心血管重构的关系

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第1期
页码:
80-81,85
栏目:
临床研究
出版日期:
2010-10-27

文章信息/Info

Title:
Association between morning blood pressure surge and cardiovascular remodeling in patients with hypertension
作者:
李萍1李俭春1周国宝2 孙康云2
1.南京军区南京总医院心内科,江苏 南京 210002;2.南京医科大学附属苏州医院心内科,江苏 苏州 215001
Author(s):
LI Ping1 LI Jian-chun1 ZHOU Gou-bao2 SUN Kang-yun2
1.Department of Cardiology, General Hospital, Nanjing Military Area Command, Nanjing 210002, Jiangsu, China; 2.Department of Cardiology, Suzhou Hospital, Nanjing Medical University, Suzhou 215001, Jiangsu, China
关键词:
血压晨峰 心血管重构 左心室肥厚颈动脉
Keywords:
morning blood pressure surge cardiovascular remodeling left ventricular hypertrophy carotid artery
分类号:
R544.1
DOI:
-
文献标识码:
A
摘要:
目的: 观察高血压病患者血压晨峰(morning blood pressure surge,MBPS)与心脏肥大和颈动脉内膜-中膜厚度(IMT)的关系。方法: 高血压病患者386例。根据动态血压检测结果,分为晨峰组(146例)和非晨峰组(240例),全部病例同步记录24 h动态血压和动态心电图,观察指标为24 h动态血压参数;超声技术检测左室质量指数(LVMI)、左房内径(LAD)、颈动脉IMT等指标。结果: 晨峰组与非晨峰组比较:LVMI分别为(119±21)g/m2和(92±12)g/m2(P<0.01) ;LAD分别为(46±11)mm与(38±10)mm(P<0.05);颈动脉IMT分别为(1.36±0.24)mm与(0.92±0.18)mm(P<0.01);左室肥厚(LVH)的检出率分别为67%与30%(P<0.01)。结论: 与无血压晨峰的高血压病患者比,具有血压晨峰的高血压病患者LVH和颈动脉硬化更显著,心血管重构更显著,左心房内径更大。
Abstract:
AIM: To evaluate the association between morning blood pressure surge (MBPS) and cardiovascular remodeling in hypertensive patients. METHODS: A cohort of 386 patients with hypertension under 24 h ambulatory blood pressure monitoring were categorized as MBPS group (n=146) and non-MBPS group (n=240). Left ventricular mass index (LVMI) and thickness (IMT) of carotid artery were measured by ultrasonography in all patients and left ventricular hypertrophy (LVH), left atrial dimension (LAD) and intima-media thickness were compared between groups. RESULTS: Compared with those in the non-MBPS group, LVMI [(119±21)g/m2 vs.(92±12)g/m2, P<0.01], LAD [(46±11)mm vs. (38±10)mm, P<0.05], IMT of carotid artery [(1.36±0.24)mm vs. (0.92±0.18)mm, P<0.05] and LVH (67% vs. 30%, P<0.01) were significantly higher in the MBPS group. CONCLUSION: Hypertensive patients with MBPS have more severe LVH and carotid atherosclerosis and larger LAD compared with those of hypertensive patients without MBPS. MBPS is associated with more significant cardiovascular remodeling.

参考文献/References

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[4]向新生,李俭春,周娟,等. 高血压病与心律失常关系的研究[J]. 中华心血管病杂志, 1995, 23(3):204-206.

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[6]周国宝,孙康云,李俭春,等. 替米沙坦联合吲达帕胺对老年原发性高血压患者脉压和血压晨峰的影响[J]. 中华高血压杂志, 2009, 17(5):406-409.

[7]Kanda R, Kario K, Hoshide S, et al. Morning blood pressure hyperactivity is an independent predictor for hypertensive cardiac hypertrophy in a community-dwelling population[J]. Am J Hypertens, 2005, 189(12pt 1):1528-1533.

[8]Leary AC, Struthers AD, Dononnan PT, et al. The morning surge in blood pressure and heart rate is dependent on levels of physical activity after waking[J]. J Hypertens, 2002, 20(5):865-870.

备注/Memo

备注/Memo:
收稿日期:2010-01-27.通讯作者:李俭春,主任医师,主要从事心血管临床及心脏起搏与电生理研究 Email:lijc2004@yahoo.com.cn 作者简介:李萍,副主任技师Email:zyyliping@sina.com
更新日期/Last Update: 2010-10-27