摘要
目的 探讨运动性高血压(exercise hypertension, EH)与动脉硬化及血压变异性的相关性。方法 以锦州医科大学附属第一医院2019年7月至2021年12月期间进行“平板运动负荷试验”检查的患者为研究对象,根据既往是否有高血压病病史及是否符合运动性高血压的诊断标准,分为血压正常无EH组(A组,42例)、血压正常EH组(B组,27例)、高血压病无EH组(C组,42例)和高血压病EH组(D组,39例)。所有受试者均行平板运动负荷试验、血生化检查、动脉硬化检测及24小时动态血压监测,记录相关指标。比较4个亚组间性别、年龄及体重指数(body mass index, BMI)、运动中最高收缩压及舒张压、甘油三酯(triglyceride, TG)、动脉硬化指数(arterosclerosis index, AI)、颈股脉搏波传导速度(cfPWV)、踝臂指数(ankle-brachial index, ABI)、24小时收缩压及舒张压变异系数(coefficient of variability, CV)、夜间血压下降率及晨峰血压水平;将运动中最高收缩压和舒张压分别与上述指标进行相关性分析。结果 4组组间比较BMI、运动中最高收缩压及舒张压、TG、AI、cfPWV、ABI、24小时收缩压及舒张压CV、夜间收缩压下降率及晨峰血压差异均有统计学意义(P<0.05)。运动中最高收缩压与BMI、TG、AI、cfPWV、ABI及晨峰血压成正相关(P<0.05),与24小时收缩压及舒张压CV成负相关(P<0.05);运动中最高舒张压与收缩压及舒张压变异CV成正相关(P<0.05)。结论(1)平板运动负荷试验可检测EH,且EH可发生于血压正常患者;(2)24小时动态血压监测对血压正常和高血压病患者的EH均有参考价值,而AI、cfPWV对高血压病患者的EH更有参考价值;(3)运动中收缩压异常升高与血脂水平、动脉硬化程度呈正相关,与血压变异性呈负相关,且运动中收缩压对运动负荷试验的反应性较舒张压敏感。
Objective To investigate the correlation between exercise hypertension(EH)and arteriosclerosis along with blood pressure variability.Methods Patients who underwent"treadmill exercise test"in the First Affiliated Hospital of Jinzhou Medical University from July 2019 to December 2021 were selected as subjects.According to the previous history of hypertension and the diagnostic criteria of exercise hypertension,the patients were divided into normal blood pressure group without EH(Group A,42 cases),normal blood pressure group without EH(Group B,27 cases),hypertension group without EH(Group C,42 cases)and hypertension group without EH(Group D,39 cases).All the subjects underwent treadmill exercise test,blood biochemical examination,arteriosclerosis test and 24-hour ambulate blood pressure monitoring and related indicators were recorded.Four subgroups were compared between sex,age,body mass index(BMI),the highest systolic blood pressure and diastolic blood pressure,triglyceride(TG),atherosclerosis index(AI),carotid-femoral pulse wave velocity(cfPWV),ankle-brachial arm index(ABI),24-hour systolic and diastolic blood pressure coefficient of variation(CV),morning peak,nocturnal blood pressure fall rate and morning blood pressure surge;the maximum systolic blood pressure and diastolic blood pressure during exercise were correlated with the above indexes.Results There were statistically significant differences in BMI,maximum systolic blood pressure and diastolic blood pressure during exercise,TG,AI,cfPWV,ABI,24-hour systolic blood pressure and diastolic blood pressure CV,nocturnal systolic blood pressure fall rate and morning blood pressure surge among the four groups(P<0.05).The maximum systolic blood pressure during exercise was positively correlated with BMI,TG,AI,cfPWV,ABI andmorning blood pressure surge(P<0.05),and negatively correlated with 24-hour systolic blood pressure and diastolic blood pressure CV(P<0.05).The maximum diastolic blood pressure during exercise was positively correlated with systolic blood pressure and diastolic blood pressure variation CV(P<0.05).Conclusion Treadmill exercise test can detect EH,and EH can occur in patients with normal blood pressure;24-hour ambulate blood pressure monitoring has reference value for EH of both patients with normal blood pressure and hypertension,while AI and cfPWV have more reference value for EH of patients with hypertension;abnormal increase of systolic blood pressure during exercise is positively correlated with blood lipid level and degree of arteriosclerosis,and negatively correlated with blood pressure variability.Systolic blood pressure during exercise is more sensitive to exercise stress test than diastolic blood pressure.
作者
杨雪
刘玉
陈东
刘叶
Yang Xue;Liu Yu;Chen Dong;Liu Ye(Electrophysiological Center,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)
出处
《锦州医科大学学报》
2023年第2期62-67,共6页
Journal of Jinzhou Medical University
基金
辽宁省科技厅2018年自然科学基金指导计划项目,项目编号:20180550419
辽宁省教育厅2019年科学研究-青年科技人才“育苗”项目,项目编号:JYTQN201926
锦州医科大学2019年大学生创新创业训练计划项目,项目编号:20190017。
关键词
运动性高血压
动脉硬化
血压变异性
平板运动试验
24小时动态血压监测
exercise hypertension
arteriosclerosis
blood pressure variability
treadmill exercise test
24-hour ambulatory blood pressure monitoring
