正常高值血压人群的血液流变性分析

目的:探讨血液流变性改变在正常高值血压中的作用。方法:用全自动血液粘度仪检测正常血压组(120例)、正常高值血压组(132例)和高血压组(124例)的血液流变学指标。结果:正常高值血压组和高血压组的全血高切粘度、全血低切粘度、血浆粘度、红细胞压积、全血高切还原粘度、全血低切还原粘度、血浆纤维蛋白原含量和红细胞聚集指数均高于正常血压组(P<0.01),高血压组高于正常高值血压组(P<0.01);正常高值血压组和高血压组的红细胞变形指数均低于正常血压组(P<0.01),高血压组又低于正常高值血压组(P<0.01)。结论:正常高值血压人群已存在血液流变性异常,血液流变性改变在高血压发生中有重要的作用。     

正常高值血压患者血流剪切力对内皮细胞功能的影响

正常高值血压被定义为收缩压在120～139mmHg和(或)舒张压在80～891mmHg,与正常血压人群相比,它发生心脑血管疾病的风险较高.正常高值血压这一概念的提出,把心血管疾病的防线从防发病前移到防危险因素,高血压与心血管疾病事件成独立线性相关.血压异常与心血管事件关系如此密切,关键在于血流对血管壁产生的异常机械力对内皮细胞功能产生影响,这已成为当前热点话题,本文就正常高值血压患者血流剪切力对内皮细胞功能影响做一综述.     

时间生物学在心血管疾病研究中的应用

作者结合本人的工作介绍了时间生物学在心血管疾病研究中的应用和最近进展。用时间生物学的原理和方法对正常人的血压和高血压患者的血压进行研究,发现了以前被临床上漏诊的隐性高血压,同时还发现有少数正常血压者被临床误诊为高血压。另外根据高血压患者血压的时间生物学特征。将其分类为调整中值高血压和振幅高血压。用时间治疗学的方法加以治疗,对不同类型的高血压其疗效不一。本文对时间生物学在心血管疾病其它方面的研究进展也作了简要介绍。时间生物学在心血管疾病中的应用,将会为临床早期诊断、治疗和预防这类疾病提供新技术和方法,推动心血管疾病的临床工作向前发展。     

内蒙古绝经后女性正常高值血压危险因素分析

目的探讨绝经后女性正常高值血压的危险因素。方法以2015年4月在内蒙古呼和浩特市赛罕区健康档案的非高血压女性人群共计2 592人,平均年龄(43±12)岁,其中未绝经女性1 895名,(37±8)岁,绝经女性697名,(58±6)岁为研究对象,通过t检验、χ~2检验和Logistic回归等方法分析绝经女性正常高值血压相关危险因素。结果绝经组收缩压、舒张压、体质指数(BMI)、空腹血糖、三酰甘油和低密度脂蛋白水平较未绝经组明显升高(P0.05);绝经组正常高值血压患病率、超重、肥胖患病率、空腹血糖受损患病率、糖尿病患病率、血脂异常患病率、三酰甘油异常患病率和低密度脂蛋白异常患病率均较未绝经组明显升高(P0.05);年龄段在55~59岁、60~64岁和65岁以上,超重、肥胖、空腹血糖受损和糖尿病为正常高值血压的独立危险因素。结论年龄≥55岁、超重、肥胖、空腹血糖受损和糖尿病为绝经女性正常高值血压的独立危险因素。     

时间生物学在心血管疾病研究中的应用

作者简要介绍了时间生物学这门新兴交叉性学科及其最近进展。结合作者本人的部分工作介绍了时间生物学在心血管疾病研究中的应用和最近进展,其中介绍了用时间生物学的原理和方法对正常人的血压和高血压患者的血压进行了研究,从而发现了以前被临床上漏诊的隐性高血压,同时在高血压患者中发现有少数是正常血压者被临床误诊为高血压。另外根据高血压患者血压的时间生物学特征,将其分类为调整中值高血压和振幅高血压。然后用时间治疗学的方法加以治疗,对不同类型的高血压其疗效不一。还介绍了时间生物学在心血管疾病的其它方面的研究进展。从而使我们看到时间生物学在心血管疾病中的应用,将会为临床早期诊断、治疗和预防这类疾病提供新技术和方法,这将推动心血管疾病的临床工作向前发展。     

有氧运动在血压控制中的作用

高血压作为一种常见慢性病,是心血管疾病的主要危险因素之一。大量研究表明有氧运动能够降低血压,改善高血压的风险因素,特别是对于血压正常高值人群和高血压患者。本文首先综述了有氧运动对高血压的有益效果和作用机制,即有氧运动能够改善外周血压、中心动脉压和心脏功能,并且对动脉硬化、内皮功能和交感神经系统活动产生有益影响。然后,介绍了高血压患者运动处方的制定规则,及其在不同特征人群中的差异性,如性别、年龄、血压基础值等,并且讨论了过量运动带来的风险和规避方法。最后,针对精准医疗的需求,结合安全性考虑,提出了为制定个性化运动处方需要开展的研究方向。     

红细胞分布宽度与高血压相关性的研究进展

红细胞分布宽度(red cell distribution width,RDW)是通过定量的方法反映循环中红细胞大小变异性的指标.近期较多研究发现RDW的升高能够作为预测人群心血管疾病预后不良的指标,即使RDW值在正常参考值范围内,处于高值的人群存在更高的心血管疾病死亡风险.本文综述了RDW与高血压发病、血压水平、血压形态及靶器官损害之间的关系,并探讨了RDW升高提示高血压预后不良的机制.由于RDW简单易得,可以作为高血压患者预后风险评估有潜力的指标.     

老年退休人群高血压与其尿酸及血脂水平的关系分析

目的:分析老年退休人群高血压与其尿酸及血脂水平的关系。方法:选取2018年1月至2020年6月期间到本院进行健康体检的退休老年人250例为研究对象,均进行血压、血脂与血尿酸等的检测,根据血压水平分为:高血压组(n=168)与血压正常组(n=82),分析高血压人群与血压正常人群其他体检生化指标的水平差异。结果:高血压组患者年龄与BMI均高于血压正常组,差异均有统计学意义(P<0.05);高血压组患者胆固醇(Cholesterol,TC)、甘油三酯(Triglycerides,TG)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)及尿酸(Uric acid,UA)水平均高于血压正常组(P<0.05);Spearman相关性分析结果显示,高血压与TC升高、TG升高、LDL-C升高及高UA均呈正相关关系(P<0.05)。结论:老年退休高血压人群有着较高的血脂及血尿酸水平,且高血压与高血脂、高尿酸的发生均密切相关,需要综合控制三项指标以提高老年退休人群的健康水平。     

时间护理对原发性高血压患者疗效的影响

原发性高血压是老年人群中最为常见的疾病之一,是影响心脑血管疾病治疗效果和预后的重要因素之一。该病病程较长,在长期的高血压应激状态下,各种靶器官严重受损,不仅给患者身体带来极大的痛苦,同时也给患者心理造成巨大的伤害。为了提高高血压患者的生活质量,降低心脑血管疾病的发病率和致死率,控制血压是最有效的方法。本文针对高血压患者采用时间护理措施,根据患者昼夜血压变化情况,适时调整服药时间和心理护理方法,可以很好地提高患者的依从性、生活质量和降压效果,现报告如下。     

单宁酸-氯化铁法对SHR脑微血管密度的观察

目前对高血压病血管病变的研究主要集中在“重构”、功能改变及其机理的研究上,也有少数研究发现高血压时血管的数量也会发生改变,即微血管减（稀）少。但是否高血压时各器官普遍存在微血管变少,以及它与高血压病发生的先后（因果）关系,仍研究不够。而且研究方法主要局限在传统的墨汁灌注法。本实验采用单宁酸一氯化铁组织化学方法媒染血管和图像分析技术对不同龄高血压大鼠和正常血压对照组大鼠脑微血管的密度进行定量分析．以进一步明确高血压状态时脑内微血管密度的变化,以及它与高血压发生发展的因果关系。     

Association of Serum γ-Glutamyltransferase Level and Incident Prehypertension in Korean Men

Several lines of evidence indicate that prehypertension is more atherogenic than normal blood pressure. Serum γ-glutamyltransferase (GGT) is known to be positively associated with prehypertensive status and the progression of hypertension. However, there have been no prospective studies of serum GGT level as a predictor of prehypertension. Apparently 13,435 healthy men (mean age 42.0 ± 6.6 yr) with normal blood pressure were included in a prospective cohort study in 2005 and were followed up to 2010 with the endpoint being incident of prehypertension. During the follow up period (median 2.80 ± 1.44 yr; actual follow-up 37,679.1 person-year), prehypertension was developed in 7,867 (58.6%) participants. Risk estimations for incident prehypertension were analyzed based on quartiles of serum GGT levels using multivariate adjusted Cox proportional hazards model. In unadjusted model, the hazard ratio for incident prehypertension for the highest 3 quartiles of baseline serum GGT level was 1.21 (1.13-1.29), 1.29 (1.21-1.38), and 1.57 (1.47-1.67) compared the lowest quartile of serum GGT level, respectively (P for trend < 0.001). These associations still remained statistically significant, even after adjusting for multiple covariates. These findings indicate that increased serum GGT level is independently associated with incident prehypertension in Korean men.     

Incidence of hypertension in Korea: 5-year follow-up study

Limited data are available about the incidence of hypertension over the 5-yr in non-hypertensive subjects. The study subjects were 1,806 subjects enrolled in a rural area of Daegu, Korea for a cohort study from August to November 2003. Of them, 1,287 (71.3%) individuals had another examination 5 yr later. To estimate the incidence of hypertension, 730 non-hypertensive individuals (265 males; mean age = 56.6 ± 11.1 yr-old) at baseline examination were analyzed in this study. Hypertension was defined as either a new diagnosis of hypertension or self-reports of newly initiated antihypertensive treatment; prehypertension was if the systolic blood pressure was 120-139 mmHg and/or diastolic blood pressure was 80-89 mmHg. During the 5-yr follow-up, 195 (26.7%) non-hypertensive individuals developed incident hypertension. The age-adjusted 5-yr incidence rates of hypertension were 22.9% (95% confidence interval [CI] = 19.9-29.0) in overall subjects, 22.2% (95% CI = 17.2-27.2) in men, and 24.3% (95% CI = 20.4-28.2) in women. The incidence rates of hypertension significantly increased with age. In the multivariate analysis, prehypertension (Odds ratio [OR] 2.25; P < 0.001) and older age (OR 2.26; P = 0.010) were independent predictors for incident hypertension. In this rapidly aging society, population-based preventive approach to decrease blood pressure, particularly in subjects with prehypertension, is needed to reduce hypertension.     

Increasing sleep duration to lower beat‐to‐beat blood pressure: a pilot study

Strong evidence has accumulated over the last several years, showing that low sleep quantity and/or quality plays an important role in the elevation of blood pressure. We hypothesized that increasing sleep duration serves as an effective behavioral strategy to reduce blood pressure in prehypertension or type 1 hypertension. Twenty‐two participants with prehypertension or stage 1 hypertension, and habitual sleep durations of 7 h or less, participated in a 6‐week intervention study. Subjects were randomized to a sleep extension group (48 ± 12 years, N = 13) aiming to increase bedtime by 1 h daily over a 6‐week intervention period, or to a sleep maintenance group (47 ± 12 years, N = 9) aiming to maintain habitual bedtimes. Both groups received sleep hygiene instructions. Beat‐to‐beat blood pressure was monitored over 24 h, and 24‐h urine and a fasting blood sample were collected pre‐ and post‐intervention. Subjects in the sleep extension group increased their actigraphy‐assessed daily sleep duration by 35 ± 9 min, while subjects in the sleep maintenance condition increased slightly by 4 ± 9 min (P = 0.03 for group effect). Systolic and diastolic beat‐to‐beat blood pressure averaged across the 24‐h recording period significantly decreased from pre‐ to post‐intervention visit in the sleep extension group by 14 ± 3 and 8 ± 3 mmHg, respectively (P < 0.05). Though the reduction of 7 ± 5 and 3 ± 4 mmHg in the sleep maintenance group was not significant, it did not differ from the blood pressure reduction in the sleep extension group (P = 0.15 for interaction effect). These changes were not paralleled by pre‐ to post‐intervention changes in inflammatory or sympatho‐adrenal markers, nor by changes in caloric intake. While these preliminary findings have to be interpreted with caution due to the small sample size, they encourage future investigations to test whether behavioral interventions designed to increase sleep duration serve as an effective strategy in the treatment of hypertension.     

The magnitude and duration of post-exercise hypotension after land and water exercises

The objective of the study was to determine and compare the magnitude and duration of post-exercise hypotension (PEH) during free-living conditions after an acute session of concurrent water and land exercise in individuals with prehypertension and hypertension. Twenty-one men and women (aged 52?±?10?years) volunteered for the study. Participants completed a no exercise control session, a water exercise session and a land exercise session in random order. After all three sessions, participants underwent 24-h monitoring using an Ergoscan ambulatory BP monitoring device. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were monitored to determine changes from resting values after each session and to compare the PEH responses between land and water exercises. During daytime, both land and water exercises resulted in significantly lower SBP (12.7 and 11.3?mmHg) compared to the control session (2.3?mmHg). The PEH response lasted for 24?h after land exercise and 9?h after water exercise. There was no difference in the daytime DBP for the three treatments (P?>?0.05). Although all three groups showed significant reductions during nighttime, both exercise treatments showed greater nocturnal falls in BP than the control treatment. This is the first study to show that the magnitude of the PEH response is similar for land and water exercises, although the duration of PEH may be longer for land exercise. These results suggest that water exercise is a safe alternative exercise modality for individuals with suspected and known hypertension.     

Dark chocolate or tomato extract for prehypertension: a randomised controlled trial

Background  

Flavanol-rich chocolate and lycopene-rich tomato extract have attracted interest as potential alternative treatment options for hypertension, a known risk factor for cardiovascular morbidity and mortality. Treatment of prehypertension (SBP 120–139/DBP 80–89 mmHg) may forestall progression to hypertension. However, there has been only limited research into non-pharmacological treatment options for prehypertension. We investigated the effect of dark chocolate or tomato extract on blood pressure, and their acceptability as an ongoing treatment option in a prehypertensive population.     

脉搏波速度在高血压病早期干预中的临床意义

目的探讨脉搏波传导速度（PWV）与高血压病早期干预的相关性及其相关因素。方法应用脉搏波速度自动测量系统对104例健康人和397例高血压病患者进行肱动脉-踝动脉脉搏波传导速度（baPWV）检测。结果高血压患者的脉搏波传导速度显著高于健康人（P〈0.01）。年龄是影响健康人大动脉弹性功能最主要的因素,年龄、收缩压和脉压与高血压患者的大动脉弹性功能密切相关。结论脉搏波传导速度是敏感反映高血压大动脉弹性的重要指标,年龄、收缩压和脉压是影响baPWV值的主要因素,可作为心血管疾病的一个危险信号,以指导早期预防干预。     

胆道高压对Oddi括约肌动力学的影响

目的和方法：探讨胆道压力对Ｏｄｄｉ括约肌的影响和急性梗阻性化脓性胆管炎（ＡＯＳＣ）时胆道高压的形成机制，采用家兔复制急性胆道盲囊加压模型。结果：胆道加压至８ｋＰａ（６０ｍｍＨｇ）的数分钟内，Ｏｄｄｉ括约肌电活动明显增强；Ｏｄｄｉ括约肌压力显著升高（Ｐ＜００５），甚至出现持续痉挛；同时伴有右内脏大神经放电频率增强和动脉血压的进行性下降（Ｐ＜００５）。而用０６％利多卡因阻滞右腹腔神经丛后，再行胆道加压则以上反应不能发生。若在加压后行腹腔神经丛阻滞术，Ｏｄｄｉ括约肌收缩或痉挛也可逐渐缓解。结论：急性胆道梗阻可能诱发Ｏｄｄｉ括约肌收缩增强，使胆道内压进一步升高，形成恶性循环，机制可能与内脏神经活动有关     

Proteomic identification of differentially expressed proteins in blood exosomes of patients with hypertension

AIM: To analyze the proteins included in exosomes derived from blood of patients with hypertension and seek the main pathological changes in hypertension. METHODS: Forty-seven patients and healthy subjects were recruited and divided into two comparisons:healthy subjects vs atherosclerosis( HS vs AS),and atherosclerosis vs hypertension plus atherosclerosis( AS vs HT + AS). We extracted exosomes from blood and utilized LC-MS / MS to identify the protein expression. We used GO analysis to established the hierarchy programs of biological process and molecular function. PPI was used to find the proteins related to the terms. RESULTS: It was found that three final child terms repeatedly shown in BP of the two categories( HS vs AS and AS vs HT + AS): "signal transduction in response to DNA damage","response to zinc ion",and"platelet aggregation". It was found that two final child terms in MF of the two categories: "interleukin 2 receptor binding"and"ploy( A) RNA binding". The proteins,PSMA6,PSMA7 and CA2,were related to the terms in the two categories. CONCLUSION: We discovered that the exosome proteins may indicate the pathological changes in hypertension through the biological processes related with the specific proteins. These specific proteins,such as VCL,PSMA6,DP,AKAP,ATP5 B and CA2,can be the new indicators for severity of hypertension and new therapeutic targets.     

原发性高血压模型大鼠颌骨骨量的吸收

背景：近年研究发现,高血压病患者中骨质疏松发病率较正常人群增高。 目的：观察原发性高血压与颌骨及牙槽骨吸收的关系。 方法：选用原发性高血压大鼠,随机分为模型组和给药组,正常大鼠作为对照组。模型组和对照组均进食未添加降压药物的普通标准饲料颗粒,给药组进食添加有降压药物的标准饲料颗粒。 结果与结论：模型组大鼠从10~22周龄收缩压逐渐上升,22周龄后血压趋于稳定。给药组和对照组血压较低且平稳。同一周龄大鼠血压值模型组>给药组>对照组(P < 0.01)。模型组和给药组大鼠下颌骨骨量均低于对照组(P < 0.01)。模型组骨皮质较薄,骨小梁稀疏、纤细、弯曲不整或断离,骨髓腔扩大,给药组骨质病理变化程度较模型组减轻。结果证实,血压升高可引起原发性高血压大鼠下颌骨骨量减少,使骨小梁变细、排列紊乱,从而增加牙槽骨吸收的风险。