凌晨血压增高与亚临床动脉粥样硬化密切相关

目的探讨高血压患者凌晨血压增高(MBPS)及动态血压监测参数与颈动脉粥样硬化的关系。方法高血压患者226例,分为MBPS组(51例)与非MBPS组(175例),并根据颈动脉内膜中膜厚度(IMT)分为IMT增厚组94例和非IMT增厚组132例,分别检查血脂、动态血压监测、颈动脉超声等,比较两组之间年龄、动态血压参数以及颈动脉IMT以及斑块Crouse积分的差别。结果1)MBPS组MBPS值、凌晨平均动脉压、凌晨脉压、颈动脉IMT、斑块积分显著高于非MBPS组(P<0.05);2)颈动脉IMT增厚组MBPS值、凌晨平均动脉压、凌晨脉压、24h平均收缩压、24h平均舒张压、白昼平均收缩压、白昼平均舒张压、夜间平均收缩压、夜间平均舒张压显著高于颈动脉非IMT增厚组(P<0.05)。结论MBPS者颈动脉粥样硬化程度较高,MBPS可能促进颈动脉粥样硬化进程。

Morning Blood Pressure Surge Associates with Carotid Atherosclerosis

Objective To investigate the association between morning blood pressure surge(MBPS)and the ambulatory blood pressure monitoring parameters on carotid artery intima-media thickness(IMT)in hypertensive patients.Methods Based on the occurrence of MBPS two hundred twenty six hypertensive patients were allocated as MBPS(n=51)or non-MBPS(n=175).However,based on the IMT,226 patients were stratified as IMT increased(n=94)or group normal IMT(n=132).Plasma lipids,24 h ambulatory blood pressure monitoring(ABPM)and ultrasound examinations of the IMT of carotid arteries were determined.Results 1)The value of MBPS,mean arterial pressure(MAP),morning pulse pressure(MPP),carotid artery IMT,carotid artery crouse score in MBPS group were significantly higher than that in no MBPS groups(P<0.05).2)The value of MBPS,morning MAP,MPP,24 h MSBP,24 h MDBP,d MSBP,d MDBP,n MSBP and n MDBP in IMT increased group were higher than those in group normal IMT(P<0.05).Conclusion There were more severe carotid atherosclerosis in the MBPS patients than that in no MBPS patients.Morning blood pressure surge was associated with the progress of carotid atherosclerosis.