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1.
多数研究表明 ,对于中老年而言 ,脉压较收缩压和舒张压更能反映大动脉僵硬度的变化 ,并与冠心病、脑卒中、心电图异常、心室肥厚等心血管事件呈显著相关。而新的血压参数—脉压指数 ,综合了血管的动态顺应性和固有顺应性 ,是一项值得期待的评价血管硬化的新指标。  相似文献   

2.
Ambulatory blood pressure monitoring is frequently employed in the clinical practice to improve the diagnosis of hypertension and the appropriateness of the decision regarding initiation of antihypertensive treatment. It is also frequently employed to check the efficacy of this treatment in conditions resembling daily life. This paper will describe the effect of a number of antihypertensive drugs on ambulatory blood pressure, based on data collected by our group in the past 10 years. It will then discuss the advantages of ambulatory blood pressure in studies on efficacy of antihypertensive drugs and the importance of this approach for definition of the trough-to-peak ratio of the antihypertensive effect. Some technical and clinical problems inherent to the ambulatory blood pressure monitoring approach will also be discussed.  相似文献   

3.
目的回顾性研究中、老年人脉压与脑卒中发病的关系及差异。方法对15752例年龄≥40岁的高血压普查人群进行血压测量和登记,统计分析方法采用t检验,χ2检验及二值多元Logistic回归分析。结果15752例人群中,检出脑卒中患者282例(1.8%),非脑卒中患者15470例(98.2%)。脉压平均为(47.5±11.1)mmHg。脉压随年龄的增长而升高,70岁左右达到最高峰,此后女性脉压较为平稳,男性脉压则略有下降。调整血压以外的其他因素(年龄、性别、体重指数、吸烟、饮酒、冠心病史、高胆固醇血症、糖尿病等)后,随PP水平的增高,中老年人群脑卒中患病率也随之增加。调整血压以外的其他因素后,脉压每增加10mmHg,中、老年人脑卒中危险分别增加76.0%、44.8%。校正收缩压后,脉压与中年人脑卒中呈显著负相关(B=-0.482,OR=0.618,P<0.01),与老年人脑卒中则无显著相关性;校正舒张压后,中老年人脉压与脑卒中仍显著正相关。结论中老年人群脑卒中的患病率随脉压水平的升高而增加。中年人应首先重视舒张压的控制;老年人应在降低血压的同时,尽量降低脉压水平。  相似文献   

4.
中老年人脉压与脑卒中危险的相关性   总被引:3,自引:1,他引:2  
目的 回顾性研究中、老年人脉压与脑卒中发病的关系及差异.方法 对15 752例年龄≥40岁的高血压普查人群进行血压测量和登记,统计分析方法采用t检验,χ2检验及二值多元Logistic回归分析.结果 15 752例人群中,检出脑卒中患者282例(1.8%),非脑卒中患者15470例(98.2%).脉压平均为(47.5±11.1)mm Hg.脉压随年龄的增长而升高,70岁左右达到最高峰,此后女性脉压较为平稳,男性脉压则略有下降.调整血压以外的其他因素(年龄、性别、体重指数、吸烟、饮酒、冠心病史、高胆固醇血症、糖尿病等)后,随PP水平的增高,中老年人群脑卒中患病率也随之增加.调整血压以外的其他因素后,脉压每增加10 mm Hg,中、老年人脑卒中危险分别增加76.0%、44.8%.校正收缩压后,脉压与中年人脑卒中呈显著负相关(B=-0.482,OR=0.618,P<0.01),与老年人脑卒中则无显著相关性;校正舒张压后,中老年人脉压与脑卒中仍显著正相关.结论 中老年人群脑卒中的患病率随脉压水平的升高而增加.中年人应首先重视舒张压的控制;老年人应在降低血压的同时,尽量降低脉压水平.  相似文献   

5.
Current evidence does not support the view that the claimed association between salt intake and blood pressure is causal. In intercultural studies it is impossible to distinguish between a genuinely causal relationship and a relationship due to the role of salt intake as a marker for different life-styles. Physiological studies suggest that the Western intake of salt corresponds to a physiological set point selected when free choice is offered as the mid-point between harmful physiological extremes. When flawed intervention studies are excluded there is no evidence that a moderate reduction in salt intake would produce a significant blood pressure fall in healthy individuals although blood pressure falls can be produced in some hypertensive subjects.  相似文献   

6.
7.
血压与脉压对动脉弹性指数影响-1013例人群分析   总被引:1,自引:0,他引:1  
背景 血管与心脏功能密切相关,但以往对血管功能研究较少,动脉结构与功能常相互影响,功能变化可能早于临床征状,较易复查与比较,动脉弹性为血管功能最重要指标。目的 本文观察了人群血压,脉压与大,小动脉弹性指数(C1,C2)的关系及影响因素。方法 采用HDI DO 2020测定正常人群与血压升高者C1,C2,同时采集病史,查体及作有关血生化指标。结果 男女人群C1,C2均随SBP,DBP及脉压升高(含正常范围)而明显降低。各层次男性测值均大于女性,但老年人及血压大于160/90者性别差异减少。单因相关分析,C1,C2与年龄、SBP、DBP、脉压呈负相关,年龄、SBP、DBP与C2联系强度大于C1。C1随高血压分级增加而降低,C2不明显,不同类型高血压中:ISFI之C1,C2下降最明显,药物治疗后C1,C2有改善趋势。结论 血压(即使正常范围)对C1,C2有巨大影响,尤其C2;SBP及脉压影响大于DBP,尤其C1,不同高血压分级与分型对C1,C2影响有差异,二、三级高血压对C1及ISH较对C2影响更大。药物有改善C1,C2趋势,因检测例数较少尚难结论。  相似文献   

8.
Background and objectives: Despite the high prevalence of cardiovascular disease among hemodialysis patients, the relationship between age and blood pressure (BP) is not well understood. It was postulated that the relationship of BP to age differs among hemodialysis patients versus the general population and that there is significant variability in dialysis unit BP measurements.Design, setting, participants, & measurements: To explore this hypothesis, the patterns of systolic, diastolic, mean arterial, and pulse pressures in the general population using data from National Health and Nutrition Examination Survey participants (n = 9242) were compared with those in a cohort of hemodialysis patients (n = 9849).Results: In contrast to the increase in systolic BP with age in the general population, systolic BP was elevated in young hemodialysis patients and declined slightly among the elderly. The inverted “U”-shape relationship between age and diastolic BP in the general population was absent in hemodialysis patients. Diastolic BP was elevated among hemodialysis patients <50 yr of age and declined with advancing age. Mean arterial and pulse pressures were elevated among young hemodialysis patients and exhibited less age dependency than in the general population. Variability in BP within patients was similar to that between patients.Conclusions: The relationship of BP to age differed from that in the general population. The variability in dialysis unit BP measurements may limit their use in managing hypertension and predicting outcomes. Nevertheless, dialysis unit BP measurements are necessary to minimize acute complications during the dialysis procedure.The National Health and Nutritional Examination Survey (NHANES) (1) and the Framingham Study (2) have contributed significantly to our understanding of the relationships between aging, blood pressure (BP), and cardiovascular disease (CVD). Unfortunately, these relationships have been less well characterized among hemodialysis (HD) patients despite their high prevalence of CVD (3). Although hypertension is a modifiable risk factor for CVD mortality in the general population, epidemiologic studies have failed to confirm similar relationships among HD patients. Observational data have suggested that HD patients with systolic BP (SBP) between 150 and 159 mmHg experience lower mortality than their normotensive peers, and there has been no evidence of increased mortality until SBP ≥180 mmHg (47). Speculation about the seemingly paradoxical relationship between BP and mortality has centered on the high prevalence of left ventricular systolic dysfunction; however, definitive prospective studies are lacking (3,811).The NHANES and Framingham Studies demonstrated that steady increases in SBP and gradual declines in diastolic BP (DBP) accompany aging in the general population. Hypertensive subjects <50 yr of age in the general population usually exhibit systolic and diastolic hypertension and a narrowed pulse pressure (PP), reflecting increased peripheral vascular resistance. Additionally, older individuals tend to exhibit isolated systolic hypertension and an elevated PP, reflecting reduced elastic artery compliance. Among HD patients, limited observational data indicate that the relationships between BP and age may differ from that of the general population (1214). However, a rigorous analysis analogous to the NHANES survey investigating these relationships has not been previously published. The high prevalence of accelerated vascular disease and left ventricular hypertrophy among young HD patients is consistent with the hypothesis that BP patterns may be similar to those found in older members of the general population.Several recent studies have suggested that routine measurement of BP within the dialysis unit may have limited utility in the management of hypertension and in predicting clinical outcomes (1517). These findings are consistent with the hypothesis that there may be significant variability in routine BP measurements made in the dialysis unit.The present study explored age-dependent BP parameters among HD patients as compared with the general population by addressing the following questions: 1) Do the relationships between age and BP measurements differ and if so how? 2) How variable are the values for different BP parameters within individual HD patients and across HD patients?  相似文献   

9.
背景血管与心脏功能密切相关,但以往对血管功能研究较少,动脉结构与功能常相互影响,功能变化可能早于临床征状,较易复查与比较,动脉弹性为血管功能最重要指标.目的本文观察了人群血压,脉压与大,小动脉弹性指数(C1,C2)的关系及影响因素.方法采用HDI DO 2020测定正常人群与血压升高者C1,C2,同时采集病史,查体及作有关血生化指标.结果男女人群C1,C2均随SBP,DBP及脉压升高(含正常范围)而明显降低.各层次男性测值均大于女性,但老年人及血压大于160/90者性别差异减少.单因相关分析,C1,C2与年龄、SBP、DBP、脉压呈负相关,年龄、SBP、DBP与C2联系强度大于C1.C1随高血压分级增加而降低,C2不明显,不同类型高血压中ISH之C1,C2下降最明显,药物治疗后C1,C2有改善趋势.结论血压(即使正常范围)对C1,C2有巨大影响,尤其C2;SBP及脉压影响大于DBP,尤其C1,不同高血压分级与分型对C1,C2影响有差异,二、三级高血压对C1及ISH较对C2影响更大.药物有改善C1,C2趋势,因检测例数较少尚难结论.  相似文献   

10.
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