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1.
Concordance for dyslipidemic hypertension in male twins   总被引:4,自引:1,他引:3  
Sixty cases of dyslipidemic hypertension were identified in the 1028 middle-aged, white, male twin participants in the first examination of the National Heart, Lung, and Blood Institute Twin Study (1969 to 1973). The prevalence of dyslipidemic hypertension was similar by zygosity but proband concordance was three times greater in monozygotic than dizygotic twins (0.44 [seven concordant and 18 discordant pairs] vs 0.14 [two concordant and 24 discordant pairs]), suggesting a genetic effect on the condition. Low high-density lipoprotein cholesterol level was the most common lipid abnormality in concordant pairs. Mortality from ischemic heart disease was significantly higher in individuals with dyslipidemic hypertension. Obesity and glucose intolerance were closely associated with the syndrome. Moreover, within the 18 discordant monozygotic twin pairs, the twins with dyslipidemic hypertension had gained significantly more weight as adults and were significantly heavier than their unaffected cotwins. Thus, although genetic factors may influence development of dyslipidemic hypertension, nongenetic, potentially modifiable aspects of obesity are also closely related to expression of this clinically important syndrome.  相似文献   

2.
社区高血压人群伴发代谢综合征及其组分的临床特征   总被引:3,自引:0,他引:3  
目的 分析社区高血压人群伴发代谢综合征及其组分的临床特征。方法 分别测定5628例20岁以上社区研究对象的身高、体重、腰围(W)、臀围、收缩压(SP)、舒张压(DP)、总胆固醇(TC)、甘油三酯(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、餐后2h血糖(2hPG)、空腹胰岛素(FIN)及餐后2h胰岛素(2hIN);计算体重指数(BMI)、腰臀比(WHR)、胰岛素抵抗指数(HOMA-IR)。根据1999年WHO代谢综合征诊断标准分为无代谢异常组、单纯高血压组、高血压伴1项其他代谢异常组、高血压伴2项其他代谢异常组及高血压伴3项其他代谢异常组。结果 在高血压人群中,单纯高血压占15.37%,高血压伴1项其他代谢异常占32.40%,高血压伴2项其他代谢异常占33.36%,高血压伴3项其他代谢异常占18.87%。校正年龄、性别后,高血压者无论是否伴有其他代谢异常,BMI、W、WHR、TC、TG、LDL-C、FPG、2hPG、FIN及2hIN均较无代谢异常者显著升高(P〈0.05,P〈0.01);高血压伴其他代谢异常各组的BMI、W、WHR、T,C、TG、LDL-C、FPG、2hPG、FIN、2hIN较单纯高血压组显著升高(P〈0.01)。高血压个体无论伴或不伴其他代谢异常均存在显著的胰岛素抵抗,高血压伴随的代谢综合征组分越多,胰岛素抵抗的发生频率越高。多元逐步回归分析显示。BMI、SP、FPG、2hPG、FIN、2hIN及TC均是影响HOMA-IR的危险因素。结论 社区高血压人群中,单纯高血压者少见。近85%的高血压患者存在1项或1项以上的其他代谢异常,超过1/2的高血压患者存在代谢综合征;社区高血压人群无论是否伴有其他代谢异常组分,总体脂、局部体脂、TC、TG、LDL-C、胰岛素水平均显著升高;高血压患者存在显著的胰岛素抵抗,胰岛素抵抗程度随个体合并代谢综合征组分的增多而加剧;总体脂、血糖、胰岛素、TC及SP分别是机体胰岛素抵抗的影响因素。  相似文献   

3.
邓俊  周音频  黄岚  宋耀明 《重庆医学》2008,37(11):1209-1211
目的分析有高血压阳性家族史但血压正常的健康子代,其内皮依赖性血管舒张功能和血清NO水平。方法入选有高血压阳性家族史,但本人血压正常的子代个体48例(男26例,女22例)作为家族史阳性组,取45例血压正常同时无高血压家族史的健康人作为对照组(男24例,女21例),按标准方法测定血压,计算体重指数〔体重指数(BMI)=体重(kg)/身高(m)2〕,抽取空腹静脉血查血糖、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、尿酸、肌酐以及血清NO,用无创超声法测定两组血流介导的血管扩张(FMD)和硝酸甘油介导的血管扩张(NMD)。结果与对照组比较,家族史阳性组收缩压和血尿酸水平较高(P<0.05);同时家族史阳性组FMD和血清NO水平均较正常对照组低(P<0.05),而两组间NMD差异无统计学意义。结论有高血压阳性家族史的子代健康个体,即使血压在正常范围时,也已经发生血管内皮依赖性舒张功能降低,血清NO水平下降,对这类人群应早期和严格防治。  相似文献   

4.
目的:探讨H型高血压与急性冠脉综合征发病率的关系。方法:从2011年2月~至2011年11月在湖南师范大学第一附属医院心内科住院的符合入选标准的原发性高血压患者中随机抽取171例,其中以急性冠脉综合征(ACS)入院的82例;没有合并急性冠脉综合征的原发性高血压患者89例。其中按照同型半胱氨酸水平的不同将其分为2组:同型半胱氨酸(Hcy)水平>10μmol/L为H型高血压组(H型组,n=97),Hcy水平≤10μmol/L为单纯高血压组(单纯组,n=74)。比较H型高血压组与单纯高血压组急性冠脉综合征发生率的差异。结果:H型组患者中ACS的发病率(65.853%)大于单纯高血压组ACS的发病率(48.315%)(P<0.05)。ACS组血脂水平与非ACS组血脂水平比较,ACS组血清高密度脂蛋白胆固醇水平低于非ACS患者,P<0.05;而总胆固醇(TCH)水平、甘油三脂(TG)水平、低密度脂蛋白(LDLC)水平无统计学差异。结论:H型高血压与急性冠脉综合征的发生密切相关。  相似文献   

5.
目的探究冠心病合并高血糖高血脂与同型半胱氨酸(Hcy)的相关性。方法选取2018年9月至2019年9月于本院慢性病科室参与体检的200例冠心病患者作为研究对象,根据患者血压情况分为单纯冠心病组和合并高血压组,每组100例,另选取100名健康体检者作为对照组,检测所有患者体内血脂及血清同型半胱氨酸表达量并进行相关性分析。结果单纯冠心病组及合并高血压组总胆固醇、三酰甘油、低密度脂蛋白胆固醇含量均高于对照组,高密度脂蛋白胆固醇含量低于对照组,差异有统计学意义(P<0.05)。合并高血压组总胆固醇、三酰甘油、低密度脂蛋白胆固醇含量均明显低于单纯冠心病组,高密度脂蛋白胆固醇含量低于单纯冠心病组,差异有统计学意义(P<0.05)。冠心病患者脉压差水平与总胆固醇、三酰甘油、低密度脂蛋白胆固醇及同型半胱氨酸表达量呈正相关(r=0.58、0.56、0.47、0.73,P<0.05),与高密度脂蛋白胆固醇呈负相关。冠心病患者血清中同型半胱氨酸表达量与血清中总胆固醇、三酰甘油、低密度脂蛋白胆固醇呈正相关(r=0.62、0.67、0.68,P<0.05),与高密度脂蛋白胆固醇呈负相关(r=-0.52,P<0.05)。结论临床原发性高血压患者出现冠心病主要是由于高血脂及高同型半胱氨酸血症引发,两者的协同作用能促进患者出现高血压性冠心病。  相似文献   

6.
ObjectiveTo address the association of dietary vitamins, anthropometric profile, lipid profile, antioxidant enzymes and lipid peroxidation in hypertensive participant compared with normotensive healthy controls.MethodsDietary intake of vitamins was assessed by 131 food frequency questionnaire items in both hypertensive participants and normotensive age-sex matched healthy controls. The associated changes in serum antioxidants and lipid peroxidation were also assessed along with lipid profile and anthropometric measurements in both groups of subjects under study.ResultsDietary vitamins intake was higher in hypertensive participants excepting for vitamin B2 and ascorbic acid compared to normotensive controls. Anthropometric variables in the hypertensive showed significant differences in weight, body mass index, waist circumference, hip circumference, waist-hip ratio and mid-arm circumference. The total cholesterol, low-density lipoprotein cholesterol, triglyceride were significantly higher (P<0.001) in hypertensive except high-density lipoprotein cholesterol which was significantly higher (P<0.001) in normotensive. The serum endogenous antioxidants and enzyme antioxidants were significantly decreased in hypertensive except serum albumin levels compared to normotensive along with concomitant increase in serum lipoprotein (a) malondialdehyde and conjugated diene levels.ConclusionsBased on the observations, our study concludes that hypertension is caused due to interplay of several confounding factors namely anthropometry, lipid profile, depletion of endogenous antioxidants and rise in oxidative stress.  相似文献   

7.
N Nakaya  Y Homma  H Tamachi  H Shigematsu  Y Hata  Y Goto 《JAMA》1987,257(22):3088-3093
CS-514 is a metabolic product of compactin and has a potent cholesterol-lowering effect in vitro and in animal studies by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A reductase. The efficacy and adverse effects of the agent were studied in 41 hypercholesterolemic subjects by administering daily doses of 5, 20, or 40 mg for four weeks under double-blind conditions. Mean total serum cholesterol level was reduced by 11.1% in the 5-mg group, 18.8% in the 20-mg group, and 25.3% in the 40-mg group. Marked reduction of total serum cholesterol level was also observed in heterozygous familial hypercholesterolemics. Mean low-density lipoprotein cholesterol level and apolipoprotein B concentration decreased by 38.5% and 28.8%, respectively, in the 40-mg group, while high-density lipoprotein cholesterol level increased by 11.8%. No serious clinical and laboratory abnormalities were observed. Plasma cortisol and testosterone levels were not significantly affected. These results suggest that CS-514 will be a useful agent in the treatment of nonfamilial and heterozygous familial hypercholesterolemia.  相似文献   

8.
李文英  黄俊菁 《基层医学论坛》2010,14(34):1067-1068
目的了解70岁以上老年高血压患者血脂情况,为高血压的防治提供依据。方法对84例70岁以上高血压患者采静脉血检测甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇。结果高血压组TG、TC、LDL-C比对照组明显升高,差异有统计学意义(P〈0.05)。高血压组中血脂异常者17例,占20.24%,男女差异没有统计学意义(P〉0.05)。17例血脂异常的患者中,以单纯TC升高、单纯LDL-C升高、TG加LDL-C升高为主,各占7.14%,16.67%,4.76%.结论70岁以上高血压患者血脂水平比同龄健康老人高。血脂异常以单纯TG升高、单纯LDL-C升高、TG加LDL-C升高为主。提示治疗老年高血压患者时应注意检测血脂水平,在降压的同时进行合理的调脂治疗,以更好地稳定血压,改善高血压患者的预后,并且应重视TG水平的调控。  相似文献   

9.
OBJECTIVE: To compare the prevalence of modifiable risk factors for cardiovascular disease among hypertensive and nonhypertensive adults and to estimate the effect of treating hyperlipidemia or hypertension to reduce the risk of death from coronary artery disease. METHODS: The authors evaluated a sample of 7814 subjects aged 35-74 years free of clinical cardiovascular disease from the Canadian Heart Health Surveys to estimate the prevalence of cardiovascular risk factors. They identified hyperlipidemic subjects (ratio of total cholesterol to high-density lipoprotein cholesterol [total-C/HDL-C] 6.0 [corrected] or more for men and 5.0 [corrected] or more for women) and hypertensive subjects (systolic or diastolic blood pressure 160/90 mm Hg or greater, or receiving pharmacologic or nonpharmacologic treatment). A life expectancy model was used to estimate the rate of death from coronary artery disease following specific treatments. RESULTS: An elevated total-C/HDL-C ratio was significantly more common among hypertensive than nonhypertensive men aged 35-64 (rate ratio [RR] 1.56 for age 35-54, 1.28 for age 55-64) and among hypertensive than nonhypertensive women of all ages (RR 2.73 for age 35-54, 1.58 for age 55-64, 1.31 for age 65-74). Obesity and a sedentary lifestyle were also more common among hypertensive than among nonhypertensive subjects. According to the model, more deaths from coronary artery disease could be prevented among subjects with treated but uncontrolled hypertension by modifying lipids rather than by further reducing blood pressure for men aged 35-54 (reduction of 50 v. 29 deaths per 100,000) and 55-64 (reduction of 171 v. 104 deaths per 100,000) and for women aged 35-54 (reduction of 44 v. 39 deaths per 100,000). Starting antihypertensive therapy in subjects aged 35-74 with untreated hypertension would achieve a greater net reduction in deaths from coronary artery disease than would lipid lowering. Nonetheless, the benefits of lipid therapy were substantial: lipid intervention among hypertensive subjects aged 35-74 represented 36% of the total benefits of treating hyperlipidemia in the total hyperlipidemic population. INTERPRETATION: The clustering of hyperlipidemia and the potential benefits of treatment among hypertensive adults demonstrate the need for screening and treating other cardiovascular risk factors beyond simply controlling blood pressure.  相似文献   

10.
《中国现代医生》2020,58(2):42-45
目的探讨厄贝沙坦联合阿托伐他汀治疗原发性高血压的临床效果,并分析对血脂、心功能的影响。方法选取2018年5月~2019年5月我院收治的120例原发性高血压患者,将其随机分为对照组和观察组,每组60例。对照组给予厄贝沙坦,观察组给予厄贝沙坦+阿托伐他汀。观察并比较两组临床效果、血脂、心功能及不良反应。结果 (1)临床效果。观察组总有效率为91.67%,明显高于对照组的88.33%,但差异无统计学意义(P0.05)。(2)血脂。对照组治疗后甘油三酯(TG)、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)与治疗前比较差异无统计学意义(P0.05)。观察组治疗后以上指标与治疗前比较差异有统计学意义(P0.05),组间比较差异有统计学意义(P0.05)。(3)心功能。治疗后两组左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)均低于治疗前,左心室射血分数(LVEF)高于治疗前,差异有统计学意义(P0.05),观察组以上指标与对照组比较差异有统计学意义(P0.05)。(4)不良反应。两组不良反应比较无显著性差异(P0.05)。结论厄贝沙坦联合阿托伐他汀治疗原发性高血压降压效果明显,且能有效改善血脂及心功能。  相似文献   

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