高血压患者血压变异性与5～10年复合心血管事件的关系

发布时间：2018-11-18 14:08

【摘要】：目的探究高血压患者血压变异性(BPV)与患者5~10年复合心血管事件的关系。方法回顾性分析本院于2000年1月~2005年1月收治的367例住院治疗的高血压患者,检测BPV,然后根据患者的BPV对其分组,分为高BPV高血压组(166例)和低BPV高血压组(201例),再检测两组患者的一般临床资料和生化指标,分析BPV与高血压患者复合心血管事件的关系以及影响复合心血管事件的因素。结果与正常人群相比,高血压患者的24 h平均收缩压(24 h SBP)、24 h平均舒张压(24 h DBP)、白天平均收缩压(dSBP)、夜间平均收缩压(nSBP)、白天平均舒张压(dDBP)和夜间平均舒张压(nDBP)的标准差和变异系数均明显升高,差异具有统计学意义(P0.01)。与BPV较低的高血压患者相比,BPV较高的患者中,饮酒比例、吸烟比例、糖尿病比例和冠心病史比例显著增加,差异具有统计学意义(P0.05或P0.01);生化指标的变化趋势与上述指标相似,其中尿素氮、尿酸、同型半胱氨酸、尿蛋白/肌酐比值和尿微量白蛋白增加的更加明显,差异也具有统计学意义(P0.05)。另外,与BPV较低的高血压患者相比,BPV较高的高血压患者的5年、10年复合心血管事件发生率明显增加,差异具有统计学意义(P0.05)。进一步采用Logistic多因素回归分析表明,饮酒、糖尿病、冠心病史、尿酸和同型半胱氨酸是高血压患者发生心血管事件的独立危险因素(P0.05)。结论高血压患者的BPV与患者的长期复合心血管事件之间有密切的关系,其中高BPV的高血压患者更易发生复合心血管事件。
[Abstract]:Objective to investigate the relationship between blood pressure variability (BPV) and complex cardiovascular events in patients with hypertension for 5 ~ 10 years. Methods from January 2000 to January 2005, 367 patients with hypertension treated in our hospital were retrospectively analyzed. The patients were divided into high BPV hypertension group (n = 166) and low BPV hypertension group (n = 201) according to the BPV of the patients, the patients were divided into two groups: high BPV hypertension group (n = 166) and low BPV hypertension group (n = 201). The general clinical data and biochemical indexes of the two groups were examined, and the relationship between BPV and complex cardiovascular events in patients with hypertension and the factors affecting the complex cardiovascular events were analyzed. Results compared with the normal population, the 24 h mean systolic blood pressure (24 h SBP), 24 h mean diastolic blood pressure) of hypertensive patients (24 h DBP), daytime mean systolic blood pressure (dSBP), nocturnal mean systolic blood pressure (nSBP),) The standard deviation and coefficient of variation of daytime mean diastolic blood pressure (dDBP) and night mean diastolic blood pressure (nDBP) were significantly increased (P0.01). Compared with the hypertension patients with lower BPV, the proportion of drinking, smoking, diabetes and coronary heart disease were significantly increased in the patients with higher BPV (P0.05 or P0.01). The change trend of biochemical indexes was similar to the above indexes, and the increase of urea nitrogen, uric acid, homocysteine, urinary protein / creatinine ratio and urinary microalbumin was more obvious, and the difference was also statistically significant (P0.05). In addition, compared with the hypertension patients with lower BPV, the incidence of complex cardiovascular events in the hypertension patients with higher BPV increased significantly in 5 years and 10 years, the difference was statistically significant (P0.05). Furthermore, Logistic multivariate regression analysis showed that alcohol consumption, diabetes mellitus, coronary heart disease history, uric acid and homocysteine were independent risk factors for cardiovascular events in patients with hypertension (P0.05). Conclusion there is a close relationship between BPV and long-term complex cardiovascular events in patients with hypertension, especially in patients with high BPV.
【作者单位】：解放军医学院;广州军区广州总医院干部病房一科;解放军总医院南楼临床部心血管二科;
【基金】：解放军总医院临床科研扶持基金(2012FC-TSYS-1021)
【分类号】：R544.1

【参考文献】