原发性高血压患者血压季节性改变的研究

目的探讨原发性高血压患者血压的季节性变化及其与各气象因素的关系。方法用整群抽样法抽取青州市3个乡镇的原发性高血压患者1800例，男1155例，女645例，年龄29—85岁，平均年龄61．3岁。2008年7月至2009年6月测量患者8：00～11：00时坐位肱动脉血压，每隔7～14天测量一次，共12个月。将血压值与测量时当地的气温、室温、湿度、平均气压等气象数据配对后进行多元回归分析。结果观察组的血压上半年成下降趋势，其拐点在4月份，夏季最低。下半年以9～10月份为拐点逐渐升高，冬季达高峰。除春秋季之间外，各季节间的收缩压、舒张压比较，差异均有统计学意义（P〈0．05或〈0．01）。收缩压、舒张压均与气温（beta=-0．08，t=-2．39，P〈0．05：beta=-0．24，t=-6．21，P〈0．01）、室温（beta=-0．08，t=-2．39，P〈0．05；beta=-0．24，t=-6．21，P〈0．01）成直线负相关。结论原发性高血压患者的血压存在季节性改变，血压在春、秋季出现春降秋升的明显波动，这种改变以收缩压较明显，与室温关系更密切。

A study on seasonal variation of blood pressure in patients with essential hypertension

Objective To study seasonal variation of blood pressure (BP) in patients with essential hypertension (EH) and its association with meteorological elements. Methods In total, 1800 patients with essential hypertension were recruited by cluster sampling from three townships and towns in Qingzhou,Shandong province, 1155 men and 645 women, with an average age of 61.3 years (ranging from 29 to 85years). BP was measured for all of them in sitting position at 8:00 in the morning every seven to 14 days during July 2008 to June 2009. Local meteorological data were collected accordingly such as temperature,humidity and atmospheric pressure, and multivariate regression analysis was performed to show their association. Results In general, BP in patients with EH presented a decreasing trend during the first half year of observation, with the lowest in the summer ( May to August). From September to October, their BP began to increase gradually, and reached the peak in the winter ( November to February nest year). There was significant difference in systolic BP (SBP) and diastolic BP (DBP) between various seasons (Pspring-summer = 0.002 and 0.000, Pwinter-spring = 0.001 and 0.000, Psummer-autumn = 0.045 and 0.000,Psummer-winter =0. 000 and 0. 000, Pautumn-winter =0. 000 and 0. 000, respectively), except for those between the spring and autumn. Both SBP and DBP reversely associated with outdoor air temperature and room temperature(beta= -0.08, t = -2.39, P ＜0.05 and beta = -0.24, t = -6.21, P ＜0.01,respectively), (beta = -0.08, t = -2.39, P ＜0.05 and beta = -0.24, t = -6.21, P ＜0.01,respectively). Conclusions BP in patients with EH reveals seasonal variation, with the lowest in the summer and the highest in the winter and evident fluctuation in the spring and autumn, especially in SBP,which associates with room temperature and their blood vessel elasticity.