摘要
目的探讨'隐性高血压'与中心动脉压及动脉硬化的关系.方法采用脉搏波分析仪记录89例临床诊断为血压正常(偶测血压<140/90 mm Hg)及75例高血压(偶测血压≥140/90 mm Hg或正在服用降压药物者)患者的桡动脉脉搏波,经计算机自动转换为相应的中心动脉脉搏波,并分析中心动脉压力及反映全身动脉硬化的增强指数(AIx).结果小样本人群中,隐性高血压的患病率为15.7%.与血压正常(偶测血压<140/90 mm Hg及白昼动态血压<135/85 mm Hg)组相比,隐性高血压组的血浆总胆固醇及低密度脂蛋白胆固醇浓度、饮酒的比例显著增高;中心动脉收缩压、舒张压、收缩末期压及中心动脉增强压分别增加14.8 mm Hg(CI 5.6～24.0 mm Hg)、9.1 mm Hg(CI 3.1～15.1 mm Hg)、14.0mm Hg(CI 5.8～22.2)及4.2(CI 0.6～7.8 mm Hg),增强指数增加11.9%(CI 2.8%～20.9%).虽然隐性高血压组的偶测血压显著低于高血压组,经年龄、性别及身高调整后,两组的白昼动态血压、中心动脉收缩压、舒张压、增强压及增强指数均无显著差异.结论隐性高血压患者的中心动脉压力及增强指数升高,提示动脉顺应性下降,动脉硬化.这些血液动力学的改变可能增加心血管病危险,对其进行评价有助于偶测血压正常者的危险分层.
Objective To explore whether subjects with normal causal but elevated awake ambulatory blood pressure （termed as “masked hypertension” or “white coat normotension” ） is associated with arterial stiffness. Methods Pulse waveforms were recorded from the radial artery in 89 clinically normotensive adults （causal blood pressure 〈140/90 mm Hg ） and 75 patients with true hypertension （causal blood pressure ≥140/90 mm Hg or receiving antihypertensive medications）. Central waveforms were generated by using pulse wave analysis. Central pressure and augmentation index （AIx） were determined. Results As compared with true normotensives, prevalence rate of masked hypertension （MHT） was 15.7 % in this cohort （n=164） of clinically normotensive adults. Patients with MHT had greater prevalence of drinking, higher plasma total cholesterol and low-density lipoprotein cholesterol level than those with true normotension. Central SBP, DBP, end systolic pressure and augmentation pressure in patients with MHT were higher by 14.8 mm Hg（CI 5.6-24. 0 mm Hg）, 9. 1 mm Hg（CI 3.1-15. 1 mm Hg）, 14.0 mm Hg （CI 5.8-22. 2 mm Hg） and 4. 2 mm Hg（CI 0.6-7.8 mm Hg）, respectively, while augmentation index by 11.9% （CI 2.8%-20. 9%）. Despite lower causal BP in patients with MHT, after adjustment for age, sex and body height, there were no significantly differences in awake ABPM, central end systolic pressure, augmentation pressure and augmentation index between MHT and true hypertension. Conclusion Masked hypertension is associated with increased central pressure and arterial stiffness, which are similar to the true hypertensive. These haemodynamic changes may contribute to the increased risk of cardiovascular disease. To find masked hypertension may improve the risk stratification of individuals with apparent normal causal blood pressure.
出处
《高血压杂志》
CSCD
北大核心
2005年第12期771-775,共5页
Chinese Journal of Hypertension
关键词
隐性高血压
偶测血压
动态血压
脉搏波分析
Masked hypertension
Causal blood pressure
Ambulatory blood pressure
Pulsewave analysis
