Ambulatory blood pressure in 12-year-old children born small for gestational age

An association between low birth weight and subsequent elevated blood pressure has been demonstrated in a large number of studies, but the number of subjects born small for gestational age in these studies has been negligible. The inverse relationship between birth weight and blood pressure in children has been evaluated previously with an ambulatory blood pressure device, but only in children with normal birth weights. In this prospective case-control study from birth to the age of 12, we evaluated the ambulatory blood pressures in 50 children born at term but small for gestational age and in 50 full-term children born appropriate for gestational age. Children born small for gestational age had similar mean+/-SD systolic (117.5+/-8.5 mm Hg versus 115.3+/-7.4 mm Hg, P=0.221), and diastolic (69.2+/-5.3 mm Hg versus 67.3+/-4.4 mm Hg, P=0.075) 24-hour ambulatory blood pressure compared with the values of the children born appropriate for gestational age. However, 24-hour systolic blood pressure in the small-for-gestational-age children was higher (3.90 mm Hg; 95% confidence interval, 0.65 to 7.15) after adjusting for current body mass index. The difference in current body mass index was the only determinant for the difference in systolic blood pressure between the groups. Birth weight had no direct association with the blood pressure values. Impaired fetal growth may have a relationship with higher later blood pressure, but in 12-year-old children, blood pressure differences between small for gestational age and appropriate for gestational age children are much more dependent on current body size.     

Altered cardiovascular rhythmicity in children born small for gestational age

Low birth weight is frequently associated with a disproportionately high incidence of cardiovascular disease, diabetes mellitus, and kidney disease in adulthood. Epidemiological studies have identified an inverse association between low birth weight or being small for gestational age and hypertension in adulthood. We hypothesized that children born with low birth weight might have altered circadian and ultradian cardiovascular rhythmicity independent of the prevailing blood pressure level. Twenty-four-hour ambulatory blood pressure and heart rate rhythmicity was prospectively evaluated by Fourier analysis in a cohort of healthy children born with low birth weight and compared with normative pediatric data. Seventy-five children born small for gestational age (mean age, 8.1±2.2 years) and 139 controls matched for age and sex were investigated. In addition to increased 24-hour, daytime, and especially nighttime blood pressure levels (P<0.05), children born small for gestational age exhibited blunted circadian (24-hour) and ultradian (12-, 8-, and 6-hour) blood pressure rhythmicity (P<0.05). In a multivariate analysis including children born with low birth weight and controls, being born with low birth weight independently influenced ultradian blood pressure rhythmicity, whereas in a multivariate analysis including children born with low birth weight only, circadian and ultradian rhythms were independently influenced by catch-up growth, gestational age, and blood pressure level. This study demonstrates blunted circadian and ultradian cardiovascular rhythmicity in prepubertal children born small for gestational age, independent from the presence of arterial hypertension. Circadian and ultradian rhythms may be sensitive indicators for detecting subtle early abnormalities of cardiovascular regulation.     

The impact of birth weight on pulse pressure during adolescence

BACKGROUND: The objective was to study the influence of birth weight on office and ambulatory pulse pressure. METHODS AND RESULTS: Three hundred healthy children (176 girls), aged 10-18 years, born at term after a normotensive pregnancy were included. The subjects were divided according to birth weight: 2.000-2.500 kg, 2.501-3.000 kg, 3.001-3.500 kg and >3.500 kg. For each subject, office and 24-h ambulatory blood pressure monitoring were performed according to the protocol designed. There were significant differences among groups in 24-h ambulatory systolic blood pressure, and pulse pressure (PP). No differences were observed in terms of sex, current age, weight and height. Using a multiple linear regression analysis, sex, but not birth weight was the only independent factor related to office PP after controlling for current age, weight and height. Twenty-four hour pulse pressure was significantly related not only to current weight but also inversely to birth weight after controlling for sex, current age, and height. CONCLUSIONS: The results disclose a relationship between birth weight and ambulatory pulse pressure while seeking to advance knowledge about the possible associations between birth weight and cardiovascular risk.     

Ambulatory blood pressure and left ventricular mass index in hypertensive children

To determine whether ambulatory blood pressure is more predictive of left ventricular hypertrophy than is casual blood pressure in hypertensive children, echocardiography and ambulatory blood pressure data from 37 untreated hypertensive children were analyzed. Left ventricular mass was calculated using the Devereux equation, left ventricular mass index was calculated as left ventricular mass (in grams)/height(2.7) (in meters), and left ventricular hypertrophy was defined as left ventricular mass index >51 g/m(2.7). Average blood pressure, blood pressure load, and blood pressure index (average blood pressure divided by pediatric ambulatory blood pressure 95th percentile) were calculated. Left ventricular mass index was strongly correlated with 24-hour systolic blood pressure index (r=0.43, P=0.008) and was also correlated with 24-hour systolic blood pressure (r=0.34, P=0.037), 24-hour systolic blood pressure load (r=0.38, P=0.020), wake systolic blood pressure load (r=0.37, P=0.025), sleep systolic blood pressure (r=0.33, P=0.048), and sleep systolic blood pressure load (r=0.38, P=0.021). Left ventricular mass index did not correlate with age, weight, clinic blood pressure, or ambulatory diastolic blood pressure. The overall prevalence of left ventricular hypertrophy was 27%. The prevalence of left ventricular hypertrophy was 47% (8 of 17) in patients with both systolic blood pressure load >50% and 24-hour systolic blood pressure index >1.0, compared with 10% (2 of 20) in patients without both criteria (P=0.015). These data suggest ambulatory blood pressure monitoring may be useful for the clinical assessment of hypertensive children by identifying those at high risk for the presence of end organ injury.     

The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation provides a better definition of cardiovascular burden associated with CKD than the Modification of Diet in Renal Disease (MDRD) Study formula in subjects with type 2 diabetes

Differences in 24 h blood pressure (BP) monitoring parameters such as average 24 h BP, day to night BP ratio and BP variability could have an impact in arterial stiffness. The study hypothesis was that despite similar average BP values in ambulatory blood pressure monitoring subjects with increased 24 h BP variability may have increased arterial stiffness. The study population consisted of 115 consecutive young healthy volunteers. Carotid-femoral PWV was measured in all subjects. Clinic BP was measured and an appropriate cuff was fitted on the non-dominant arm of each subject for a 24 h ambulatory blood pressure monitoring session. Waist to hip ratio as well as BMI was measured. Family history and smoking habits were recorded. In univariate analysis, estimated carotid-femoral PWV showed a significant correlation with age, weight, waist circumference, height, clinic systolic and diastolic BP, 24-h systolic and diastolic BP, 24-h pulse pressure, 24-h systolic and diastolic BP variability, daytime systolic and diastolic BP, daytime pulse pressure, daytime systolic and diastolic BP variability, nighttime systolic BP, nighttime pulse pressure and nighttime systolic BP variability. In multivariate regression analysis, age (B=0.95, P<0.001) and 24 h systolic BP variability (B=0.28, P<0.001) were independent determinanats of arterial stiffness. In conclusions, increased 24 h systolic BP variability is associated with arterial stiffness in young healthy volunteers. Pulse wave velocity in a young healthy population is useful to identify determinants of premature arterial stiffness, thus further elucidating the aspects of early vascular ageing.     

高血压患者动态动脉僵硬指数与血压变异性的关系

目的探讨高血压患者动态动脉僵硬指数(AASI)与血压变异性(BPV)的关系。方法入选2009-03-2011-10中国医科大学附属第一医院就诊的高血压患者119例,所有患者均行24h动态血压监测。AASI定义为1减去24h舒张压和收缩压的回归系数。依据AASI水平,分为4组:AASI<0.30、0.30～<0.41、0.41～<0.52、≥0.52。结果相关性分析显示,AASI分别与年龄(r=0.301,P<0.01)、24h收缩压(r=0.276,P=0.001)、白昼收缩压(r=0.225,P=0.008)、夜间收缩压(r=0.366,P<0.01)、24h脉压(r=0.510,P<0.01)、24h收缩压标准差(r=0.297,P=0.001)呈正相关,而与24h舒张压标准差(r=-0.256,P=0.002)、24h平均心率标准差(r=-0.205,P=0.017)及24h平均动脉压标准差(r=-0.202,P=0.017)呈负相关。多元线性逐步回归分析显示,AASI与24h脉压和24h收缩压标准差呈正相关(β=0.321,β=0.725,均P<0.01),与24h舒张压标准差和24h平均动脉压标准差呈负相关(β=-0.428,β=-0.346,均P<0.01)。结论 AASI与BPV密切相关。     

Relationship between birth weight and blood pressure variability in children

This cross-sectional study investigates the relationship between birth weight, 24-h blood pressure and blood pressure variability in childhood. Blood pressure was measured in 976 schoolchildren, free from cardiovascular disease, aged between 6 and 16 years. Blood pressure variability was estimated as the standard deviation of the 24-h mean (systolic and diastolic) blood pressure values. Linear regression showed that variation in systolic or diastolic blood pressure was not significantly associated with birth weight. Similarly, no association was found between blood pressure variability and birth weight when using the birth weight groups used by a previous study. Adjusting for other covariates, including mean 24-h blood pressure, made little difference to the observed results. No interactions were observed between birth weight and either gender or age on blood pressure variability. The results of this study do not support the suggestion of a significant association between birth weight and blood pressure variation in childhood. This might suggest that blood pressure variability is influenced mainly by environmental or lifestyle factors, but as little research has been published in this area, further investigation is required and in particular it would be important to assess the use of other measures of blood pressure variation.     

Blood pressure variability and silent cerebral damage in essential hypertension

BACKGROUND: It is recognized that blood pressure (BP) variability has prognostic significance in determining target organ damage and cardiovascular mortality and morbidity. The aim of this study was to analyze the association between blood pressure variability and the presence of silent cerebral white matter lesions in middle-aged asymptomatic essential hypertensives. METHODS: We studied 43 middle-aged untreated hypertensive patients. Blood pressure variabilities (short-term and long-term) were evaluated by using both non-invasive, beat-to-beat, continuous finger 24-hour monitoring (Portapres) and oscillometric automated discontinuous ambulatory blood pressure monitoring. All patients underwent cerebral magnetic resonance imaging to detect the presence or not of white matter lesions. RESULTS: Hypertensive patients with cerebral white matter lesions exhibited significantly higher values of long-term systolic blood pressure variability (standard deviation of 24-hour blood pressure) measured both by continuous beat-to-beat monitoring (16.2 +/- 3.7 v 13.7 +/- 3.6 mm Hg; P = 0.047) and by ambulatory blood pressure monitoring (15.2 +/- 3.8 v 12.8 +/- 2.7 mm Hg; P = 0.022). However, these differences were not independent on blood pressure elevation and did not maintain their significance after adjusting for 24-hour systolic blood pressure. Neither short-term systolic blood pressure variability, nor short-term or long-term diastolic blood pressure variabilities showed differences between patients with and without white matter lesions. CONCLUSION: The present study indicates that long-term systolic blood pressure variability is significantly related to the presence of silent cerebral white matter lesions in essential hypertensive patients, although this relationship is partially dependent on absolute blood pressure elevation.     

Enhanced blood pressure variability in a high cardiovascular risk group of African Americans: FIT4Life Study

High blood pressure (BP) levels in African Americans elicit vascular inflammation resulting in vascular remodeling. BP variability (BPV) correlates with target organ damage. We aimed to investigate the relationship between inflammatory markers and BPV in African Americans. Thirty-six African Americans underwent 24-hour ambulatory BP monitoring (ABPM). BPV was calculated using the average real variability index. Fasting blood samples were assayed for high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), and white blood cell (WBC) count. Significant associations between hs-CRP and 24-hour systolic variability (r = 0.50; P = .012) and awake systolic variability (r = 0.45; P = .02) were identified after adjusting for age, body mass index, and 24-hour mean BP. ABPM variables were compared between the hs-CRP tertile groups. In post-hoc analysis, there was a significant difference in 24-hour and awake periods for both systolic and diastolic variability among the groups. TNF-α and WBC count showed no associations with ABPM variables. hs-CRP was associated with systolic variability, and higher levels of hs-CRP were related with greater BPV. Higher inflammatory status influences wider fluctuations in systolic BP, which in turn could facilitate early progression to target organ damage independent of absolute BP levels in African Americans.     

Prognostic Value of Direct, Continuous Ambulatory Blood Pressure Monitoring in Essential Hypertension

This study assessed the prognostic value of ambulatory vs. clinic blood pressure measurement in 688 hypertensives who had undergone pretreatment 24-hour intra-arterial ambulatory blood pressure monitoring. A total of 157 first events were recorded over a follow-up period of 9.2±4.4 years. Ambulatory systolic or diastolic blood pressure parameters (whether 24-hour mean, daytime mean, or nighttime mean) or ambulatory pulse pressure provided independent prognostic information in conjunction with clinical variables. The most predictive models contained the ambulatory systolic blood pressure parameters. Age, male gender, South Asian origin, diabetes mellitus, and previous cardiovascular disease were additional independent predictors of events. In a subgroup of 295 uncomplicated patients, 24-hour ambulatory pulse pressure was an independent predictor of left ventricular mass index and maximal carotid intima-media thickness. Baseline clinic blood pressure parameters did not provide independent information for the prediction of events or target organ damage. Therefore, in this study, ambulatory blood pressure proved to be superior to clinic measurement for cardiovascular risk stratification. However, the routine use of ambulatory blood pressure monitoring is not currently recommended, mainly because of a lack of outcome trials based on the treatment of ambulatory blood pressure levels.     

Twenty-four-hour ambulatory blood pressure in children with sleep-disordered breathing

Obstructive sleep apnea causes intermittent elevation of systemic blood pressure (BP) during sleep. To determine whether obstructive apnea in children has a tonic effect on diurnal BP, 24-hour ambulatory blood pressure was obtained from 60 children with mean age of 10.8 +/- 3.5 years. Thirty-nine children had obstructive apnea and 21 had primary snoring. Children with obstructive apnea had significantly greater mean BP variability during wakefulness and sleep, a higher night-to-day systolic BP, and a smaller nocturnal dipping of mean BP. Variability of mean arterial pressure during wakefulness was predicted by the desaturation, body mass, and arousal indices, whereas variability during sleep was predicted by apnea-hypopnea and body mass indices. Nocturnal BP dipping was predicted by the desaturation index. There were no significant differences in systolic, diastolic, or mean arterial BP during sleep between the groups. Diastolic BP during wakefulness was significantly different between the groups and correlated negatively with apnea-hypopnea index. We conclude that obstructive apnea in children is associated with 24-hour BP dysregulation and that, independent of obesity, the frequency of obstructive apnea, oxygen desaturation, and arousal contributes to abnormal BP control.     

Prevalent influence of systolic over pulse pressure on left ventricular mass in essential hypertension.

BACKGROUND: Elevated pulse pressure, an index of increased large artery stiffness, has been associated with increased left ventricular mass. It is unknown whether this relation is independent or mediated by other blood pressure components. METHODS AND RESULTS: We examined data in 2545 untreated hypertensive subjects (45% women) who underwent echocardiography and 24-h ambulatory blood pressure monitoring. Left ventricular mass increased with all blood pressure components and all associations were closer with ambulatory than with office blood pressure. In a multiple regression analysis, after adjustment for the significant association with age, gender, body weight and duration of hypertension, the proportion of variability of left ventricular mass explained by systolic blood pressure was greater than that explained by other blood pressure components. When different blood pressure components were forced into the same model, the same degree of left ventricular mass variability was accounted for by models including 24-h systolic blood pressure alone, or 24-h mean blood pressure plus 24-h pulse pressure, or 24-h diastolic blood pressure plus 24-h pulse pressure. When 24-h systolic blood pressure and 24-h pulse pressure were forced into the same model, 24-h pulse pressure lost statistical significance. CONCLUSIONS: The association between pulse pressure and left ventricular mass is explained by systolic blood pressure, which is the main pressure determinant of left ventricular mass in essential hypertension.     

Adolescent pain sensitivity is associated with cardiac autonomic function and blood pressure over 8 years

Low pain sensitivity has been reported in hypertensive subjects as well in groups deemed to be at increased risk of development of the disorder. However, it is uncertain whether individual differences in pain sensitivity are associated prospectively with increases in blood pressure. In the current study, 24-hour blood pressure and heart rate variability were recorded in 110, 22-year-old men previously assessed at age 14 years for casual blood pressure and pain sensitivity (mechanical finger pressure). Significant correlations were observed between pain tolerance in 14-year-olds and current 24-hour systolic blood pressure (r=0.37, P<0.01) and diastolic blood pressure (r=0.36, P<0.01). Hierarchical multiple regression analyses indicated that information regarding pain tolerance improved prediction of systolic and diastolic blood pressure at age 22 years beyond that afforded by differences in blood pressure, parental history of hypertension, and body mass index at age 14 years. Similar analyses revealed that average pain sensitivity at age 14 was also associated with 24-hour high-frequency heart rate variability (r=0.28, P<0.01) and low-frequency/high-frequency heart rate variability at age 22 (r=-0.35, P<0.01), suggesting increased sympathetic and reduced parasympathetic tone among individuals less sensitive to pain. These results provide further evidence that blood pressure related hypoalgesia might be related to processes involved in blood pressure regulation as well as in the development of sustained high blood pressure.     

Impact of obesity on 24-hour ambulatory blood pressure and hypertension

The purpose of the present study was to determine the relationship between body mass index (BMI) and parameters derived from 24-hour ambulatory blood pressure monitoring including mean 24-hour daytime and nighttime systolic and diastolic blood pressures, 24-hour daytime and nighttime pulse pressure, mean 24-hour daytime and nighttime heart rate, dipping and nondipping status. 3216 outpatient subjects who visited our hypertension center and were never treated with antihypertensive medication underwent 24-hour blood pressure monitoring. BMI was significantly correlated with clinic systolic and diastolic blood pressures. Significant correlations were also found between BMI and mean 24-hour daytime and nighttime systolic blood pressure, 24-hour daytime and nighttime pulse pressure, and mean 24-hour daytime and nighttime heart rate. In multivariate regression analysis, clinic systolic, diastolic blood pressure, mean 24-hour systolic blood pressure, 24-hour pulse pressure, and high-density lipoprotein were independently correlated with BMI. The incidence of white coat hypertension was higher in overweight and obese patients than in normal weight subjects. Confirmed ambulatory blood pressure hypertension was also found to be higher in overweight and obese individuals compared with normal weight subjects. Our data also highlight the higher incidence of nondipping status in obesity. These findings suggest that obese patients had increased ambulatory blood pressure parameters and altered circadian blood pressure rhythm with increased prevalence of nondipping status.     

Racial aspects of ambulatory blood pressure.

Ambulatory blood pressure measurements, recorded by a Del Mar Pressurometer IV, were performed in 71 patients (25 blacks and 46 whites) with documented essential hypertension (supine diastolic blood pressure 95-119 mmHg) after four weeks of placebo treatment. Each 24-hour ambulatory BP measurement was calibrated with manual measurements within 5 mmHg and was repeated according to the daily conditions (work status) of the original recording. Ambulatory BP measurements were recorded every 15 minutes over 24 hours on two separate occasions one week apart. The mean of two 24-hour measurements was the value for the individual patient. Analyses of variance indicated no significant difference in the mean age, height, weight, 24-hour ambulatory systolic or diastolic BP, 8 am to 12 noon systolic or diastolic ambulatory BP, or 12 midnight to 4 am ambulatory systolic or diastolic BP for blacks versus whites. Among the subset of females, the 20 blacks were older than the 23 whites. Despite this age difference, there was no significant difference in height, weight or 24-hour, 8 am to 12 noon, or 12 midnight to 4 am ambulatory BP measurements. Therefore, this study does not support a racial difference in the level of ambulatory blood pressure measurement in these hypertensive patients.     

Relationship between birth weight and awake blood pressure in children and adolescents in absence of intrauterine growth retardation

This study was designed to examine the relationship between birth weight (BW) and ambulatory blood pressure in children and adolescents, born at term in absence of intrauterine growth retardation.Twenty-four hour ambulatory blood pressure monitoring (ABPM) was performed on 332 children (150 boys), aged from 6 to 16 years. Subjects were stratified by BW textiles and age. ABPM was performed using SpaceLabs 90207 monitor during a regular school day. Blood pressure (BP) was measured every 20 min from 06:00 to 24:00, and thereafter every 30 min. Means of systolic BP (SBP) and diastolic BP (DBP) during 24 h, daytime (08:00 to 22:00), and nighttime (24:00 to 06:00) were calculated. Systolic and diastolic load was estimated as the percentage of measurements above the age- and sex-specific 95th percentile during the 24 h.BW was inversely related to daytime SBP (P = .04) and SBP load (P = .04) when controlled for sex, current height, ponderal index (weight/height³). and age. The predictive values of daytime SBP throughout the pediatric age group in the two extreme tertiles of BW (lowest, 2.500 to 3.200 kg and highest, 3.501 to 4.820 kg) were obtained from regression equations including SBP during activity period or SBP load and age. Children who had lower BW tended to have higher daytime SBP or SBP load at any age although this difference was not statistically significant. These differences became more evident as the subjects got older. BW is a determinant of daytime SBP even in the absence of intrauterine growth retardation. The influence of BW seems to increase with age.     

Daily life blood pressure changes are steeper in hypertensive than in normotensive subjects

Target organ damage in hypertensive patients is related to their increased average blood pressure and greater 24-hour blood pressure variability. Whether the rate of blood pressure changes is also greater in hypertension, producing a greater stress on arterial walls, is not known, however. Our study aimed at addressing this issue by computer analysis of 24-hour ambulatory intra-arterial blood pressure recordings in 34 subjects (29 males), 13 normotensive subjects and 21 uncomplicated hypertensive subjects (mean age+/-SD, 40.4+/-11.8 years). The number, slope (mm Hg/s), and length (beats) of systolic blood pressure ramps of 3 or more consecutive beats characterized by a progressive increase (+) or reduction (-) in systolic blood pressure of at least 1 mm Hg per beat were computed for each hour and for the whole 24-hour period. Twenty-four-hour average systolic blood pressure was 112.9+/-2.1 and 159.4+/-5.7 mm Hg in normotensive and hypertensive subjects, respectively. Over the 24 hours, the number and length of systolic blood pressure ramps were similar in both groups, whereas the slope was markedly different (24-hour mean+/-SE slope, 4.80+/-0.30 in normotensives and 6.50+/-0.40 mm Hg/s in hypertensives, P<0.05). Ramp slope was not influenced by age or reflex pulse interval changes, but it was greater for higher ramp initial systolic blood pressure values. Thus, in daily life, hypertensive subjects are characterized by steeper blood pressure changes than normotensives, and this, regardless of the mechanisms, may have clinical implications, because it may be associated with greater traumatic effect on the vessel walls of hypertensive patients.     

缓解期慢性支气管炎对高血压患者血压变异性的影响研究

背景 慢性支气管炎与高血压存在共同的危险因素,但目前国内外尚缺乏关于缓解期慢性支气管炎与高血压患者血压变异性关系的研究.目的 探讨缓解期慢性支气管炎对高血压患者血压变异性的影响.方法 选取2019年7月—2020年2月在宣城市人民医院心血管内科治疗的高血压患者160例为研究对象.根据患者临床诊断是否合并缓解期慢性支气管...     

Systematic review and meta-analysis of preterm birth and later systolic blood pressure

Lower birth weight because of fetal growth restriction is associated with higher blood pressure later in life, but the extent to which preterm birth (<37 completed weeks' gestation) or very low birth weight (<1500 g) predicts higher blood pressure is less clear. We performed a systematic review of 27 observational studies that compared the resting or ambulatory systolic blood pressure or diagnosis of hypertension among children, adolescents, and adults born preterm or very low birth weight with those born at term. We performed a meta-analysis with the subset of 10 studies that reported the resting systolic blood pressure difference in millimeters of mercury with 95% CIs or SEs. We assessed methodologic quality with a modified Newcastle-Ottawa Scale. The 10 studies were composed of 1342 preterm or very low birth weight and 1738 term participants from 8 countries. The mean gestational age at birth of the preterm participants was 30.2 weeks (range: 28.8-34.1 weeks), birth weight was 1280 g (range: 1098-1958 g), and age at systolic blood pressure measurement was 17.8 years (range: 6.3-22.4 years). Former preterm or very low birth weight infants had higher systolic blood pressure than term infants (pooled estimate: 2.5 mm Hg [95% CI: 1.7-3.3 mm Hg]). For the 5 highest quality studies, the systolic blood pressure difference was slightly greater, at 3.8 mm Hg (95% CI: 2.6-5.0 mm Hg). We conclude that infants who are born preterm or very low birth weight have modestly higher systolic blood pressure later in life and may be at increased risk for developing hypertension and its sequelae.     

非酒精性脂肪肝并发原发性高血压患者与血压变异性的关系

目的 探讨非酒精性脂肪肝(Non-alcoholic Fatty Liver Disease,NAFLD)并发原发性高血压对血压变异性的影响.方法 纳入在2019年9月～2020年7月就诊于宣城市人民医院心血管内科的原发性高血压患者206例,进行动态血压、动态心电图及腹部超声检查.以动态血压测量参数中24 h收缩压变异...