不同管理模式退休糖尿病患者病情控制状况及其相关因素研究

目的比较不同管理模式退休糖尿病患者病情控制状况及其相关因素研究。方法选取2013年8月至2014年6月许昌东大社区老年人健康状况调查研究中2型糖尿病患者250例为社区组,另选取同期在许昌卫生学校附属医院体检并确诊为T2DM的老干部患者250例为干部组,通过1 a不同的医疗保健后,比较两组患者的血糖控制水平和达标情况。结果干部组患者FBG、Hb A1c、收缩压、舒张压、TG、TC均较社区组低,FBG、Hb A1c、血压、TG、TC达标率均较社区组高(P<0.001)。年龄≥80岁、女性、糖尿病病程≥10 a、BMI≥24 kg/m~2、FBG≥7.2 mmol/L、血压≥130/80 mm Hg、LDL-C≥2.6 mmol/L、TG≥1.7 mmol/L、TC≥4.5 mmol/L的患者Hb A1c达标率较高,性别、糖尿病病程、FBG、LDLC、TG、TC,χ~2趋势检验差异均有统计学意义(P<0.05)。不同医疗保健、性别、糖尿病病程、FBG、TC是患者Hb A1c达标的影响因素(P<0.05),不同医疗保健对Hb A1c达标影响最大(OR=8.542,95%CI=4.285~17.029)。结论社区组T2DM患者的血糖控制水平及达标率均较干部组差。     

洛阳市383例冠心病患者多种危险因素达标率分析

目的了解已诊断为冠心病患者各种危险因素治疗达标率情况。方法以383例已被诊断为冠心病的患者为调查对象,依据中国成人血脂防治指南对各种危险因素的控制建议分析该群患者的治疗控制情况。结果总胆固醇〈4．14mmol／L的比率为9．92％（38／383）,甘油三酯〈1．70mmol／L的比率为20．6％（79／383）,低密度脂蛋白胆固醇（LDL—C）〈2．59mmol／L的比率为10．7％（41／383）,高密度脂蛋白胆固醇（HDL—C）〉1．04mmol／L的比率为70．8％（271／383）;收缩压〈140mmHg（1mmHg=0．133kPa）的比率为44．9％（172／383）,舒张压〈90mmHg的比率为39．7％（152／383）,血压（BP）〈140／90mmHg的比率为26．4％（101／383）;空腹血糖〈6．1mmol／L的比率为73．4％（281／383）,餐后2h血糖〈7．8mmol／L的比率为76．9％（302／383）;男性腰围〈90cm的比率为19．9％（40／201）,女性腰围〈85cm的比率为17．6％（32／182）;不吸烟的比率为94．3％（361／383）。将LDL—C〈2．59mmol／L,BP〈140／90mmHg,空腹血糖〈6．1mmol／L,男性腰围〈90cm,女性腰围〈85cm,不吸烟定义为全面达标,全面达标率为4．96％（19／383）。结论洛阳市某区冠心病患者的全面达标率较低,应加强综合防治。     

高血压患者60例整体护理干预效果观察

目的：探讨整体护理干预在高血压治疗中的应用效果。方法：回顾性分析我院2011年4月至2012年9月诊治的高血压患者60例,随机分为观察组和对照组各30例。观察组给予整体护理干预,对照组行常规护理,对比两组患者血压达标率。结果：观察组血压达标26例,达标率86．7％;对照组血压达标16例,达标率53．3％。观察组达标率显著高于对照组（x^2=7．9365,P〈0．01）。观察组舒张压和收缩压明显低于对照组（收缩压比较,t=4．9057,P〈0．01;舒张压比较,t=10．2362,P〈0．01）。结论：护理干预对高血压患者的血压达标起重要作用,杜绝或延缓并发症的发生,提高患者的生活质量。     

上海市江宁路街道所辖社区确诊2型糖尿病患者治疗达标率分析

目的了解上海市中心城区江宁路街道所辖社区30岁以上已诊断2型糖尿病者治疗达标率情况。方法以静安区江宁路街道所辖社区642例30岁以上已诊断2型糖尿病患者为调查对象,依据国际糖尿病联盟西太平洋地区糖尿病治疗控制建议分析该群患者的治疗控制情况。结果空腹血糖4．4—6．1mmol／L的比率为17．4％（112／642）,糖化血红蛋白（HbA1c）〈6．5％的比率为37．5％（241／642）。收缩压〈130mmHg（1mmHg=0．133kPa）的比率为23．8％（153／642）,舒张压〈80mmHg的比率为18．1％（116／642）,血压〈130／80mmHg的比率为14．6％（94／642）。总胆固醇〈4．5mmol／L的比率为21．7％（139／642）,甘油三酯〈1．5mmol／L的比率为46．6％（299／642）,低密度脂蛋白胆固醇〈2．5mmol／L的比率为23．7％（152／642）,高密度脂蛋白胆固醇〉1．1mmol／L的比率为62．1％（399／642）。将HbA1c〈6．5％、血压〈130／80mmHg及低密度脂蛋白胆固醇〈2．5mmol／L定义为全面达标,全面达标率为2．6％（17／642）。结论上海市中心城区30岁以上已诊断2型糖尿病者的全面达标率较低,应加强社区综合防治。     

合理使用降压药

一、正常血压与高血压及诊断标准 1、正常血压与高血压世界卫生组织规定：随测血压值为收缩压〈18．7Kpa（140mmHg）;舒张压〈12．0Kpa（90mmHg）为正常血压;随测血压≥21．0Kpa（160mmHg）,舒张压≥12．6Kpa（95mmHg）为高血压;随测血压处在上下两界之间为临界高血压。     

胰岛素抵抗与原发性高血压的关系研究

目的探讨胰岛素抵抗与原发性高血压的关系。方法对2000例体检者在排除了高血压史、冠心病、脑血管病、糖尿病、前列腺肥大、肝炎、慢性支气管炎、胃肠炎等疾病及既往史后选取42例，根据其血压状态分为正常血压组（A组，收缩压〈120mmHg，舒张压〈80mmHg）14例，正常高值组（B组，120mmHg≤收缩压〈140mmHg或80mmHg舒张压〈90mmHg）14例，高血压组（C组，收缩压≥140mmHg或舒张压≥90mmHg）14例，分别测定其空腹血糖（FBG）、空腹血清胰岛素（FINS）值。结果与A组比较，B组胰岛素抵抗指数差异无显著性（P〉0．05），C组则显著增高（P〈0．05）；与B组相比，C组差异无显著性（P〉0．05）。结论，原发性高血压病人存在明显的胰岛素抵抗状态。     

稳定性冠心病患者低密度脂蛋白胆固醇不达标的影响因素分析

目的 分析稳定性冠心病患者低密度脂蛋白胆固醇（LDL-C）不达标的影响因素。方法 回顾性分析2017年6月～2019年3月阜阳市妇女儿童医院收治的119例稳定性冠心病患者临床资料，根据LDL-C是否达标分为LDL-C达标组（LDL-C<1.8mmol/L）29例和LDL-C未达标组（LDL-C≥1.8 mmol/L）90例，比较两组患者一般资料（在家服用他汀类型、入院时检查指标LDL-C、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇、谷丙转氨酶等），将差异有统计学意义的指标纳入logistic回归分析患者LDL-C不达标的影响因素。结果 本组119例患者LDL-C达标率为24.37%(29/119)。单因素分析显示，两组是否有高血压病史、是否服用他汀类药物、是否连续服用他汀类药物、TC、TG水平差异有统计学意义（P<0.05）。logistic多因素回归分析显示，未服用他汀类药物（OR:3.762,95%CI:1.654～8.558）、有高血压病史（OR:4.420,95%CI:1.703～11.472）为稳定性冠心病患者入院时LDL-C不达标的危险因素（P<...     

老年冠心病患者血压、血糖及血脂达标率的现况调查

目的 探讨影响老年冠状动脉粥样硬化性心脏病(CHD)患者血压、血糖及血脂达标的相关因素.方法 连续入选2006年6月至2007年1月,66家医院的心内科门诊被诊断为CHD的患者2420例(年龄均＞65岁,其中男1441例,占59.5%)进行横断面调查.结果 老年CHD患者血压达标率为24.8%(599/2420),女性低于男性[213例(21.8%)比386例(26.8%),P＜0.01];血脂达标率为36.5%(884/2420),女性明显低于男性[281例(28.7%)比603例(41.8%),P＜0.01],且老年CHD患者的血脂达标率随着年龄的增加而升高(P＜0.05);血糖达标率为61.0%(1476/2420).进行二分类Logistic向前逐步回归分析显示影响血压达标的相关因素的比值比(OR)值分别为:女性1.245[95%可信区间(CI):1.016～1.527]、高血压史2.889(95%CI:2.319～3.599)、利尿剂0.689(95%CI:0.538～0.883)、硝苯地平0.405(95%CI:0.170～0.964);影响血脂达标的相关因素的OR值分别为:女性1.750(95%CI:1.252～2.445)、高血压病程10～20年3.988(95%CI:1.951～8.152)、高血压病程20～30年2.158(95%CI:1.075～4.333)、糖尿病史3.026(95%CI:1.986～4.610)、血脂异常史2.166(95%CI:1.549～3.030)、治疗性生活方式改变(TLC)0.493(95%CI:0.302～0.805);影响血糖达标的相关因素的OR值分别为:糖尿病史3.191(95%CI:2.259～4.507)、TLC 0.690(95%CI:0.528～0.902)、利尿剂1.507(95%CI:1.150～1.975)、钙离子拮抗剂(CCB)0.718(95%CI:0.579～0.890)、口服降糖药0.477(95%CI:0.235～0.969).结论 我国老年CHD患者的血压、血脂和血糖达标率均较低,尤其是血压及血脂达标率亟待提高.老年女性CHD患者的血压及血脂达标率均显著低于男性.应针对影响我国老年CHD患者血压、血脂及血糖达标的相关因素,积极规范进行降压、调脂及降糖治疗,同时应加强对老年人群的综合管理,尤其需关注老年女性CHD患者.

Abstract：

Objective To investigate the current status of treatment goals for blood pressure, serum lipids and blood glucose in the elderly patients (＞65 years old) with coronary heart disease (CHD) in China and to identify their associated factors. Methods In this cross-sectional survey, the CHD subjects aged ＞65 years old were recruited from 66 hospitals in Beijing, Shanghai, Tianjin, Guangdong, Zhejiang and Xinjiang from June 2006 to January 2007. Results A total of 2420 participants, including 1441 males and 979 females. Their mean age was (73 ± 6) years. The targeted blood pressure was systolic blood pressure ＜ 130 mm Hg( 1 mm Hg =0.133 kPa) and diastolic blood pressure ＜80 mm Hg. And the success rate was 24.8% (559/2420). The blood pressure achievement rate among the females was 21.8%(213/979). And it was lower than 26. 8% (386/1441 ) among the males (P ＜0.01). The serum lipids goal of achievement was LDL-C ( low density lipoprotein-cholesterol) ＜ 2.6 mmol/L for the high-risk patients and LDL-C ＜ 2.07 mmol/L especially for the super-high-risk patients. The success rate for achieving the target LDL-C level was 36. 5% (884 cases). The LDL-C achievement rate among the females was 28. 7% (281 cases). And it was obviously lower than 41. 8% (603 cases) among the males (P ＜0.01). The success rate for achieving the target LDL-C level increased with aging ( P ＜ 0. 05). The blood glucose goal of achievement was FPG ( fasting plasma glucose) ＞ 4.4 mmol/L and FPG ＜ 6. 1 mmol/L The success rate for achieving the target blood glucose level was 61. 0% (1476/2420). Binary logistic regression analysis indicated that the independent risk factors of achieving the blood pressure target for the elderly CHD patients were female, history of hypertension, diuretics and nifedipine. The odds ratio (OR) of these risk factors were 1. 245 [95% confidence interval (CI): 1. 016 - 1. 527], 2. 889 (95% CI: 2. 319 -3. 599),0.689 (95% CI: 0.538 -0.883), 0.405 (95%CI: 0. 170-0.964) respectively. The independent risk factors of achieving the serum lipids target for the elderly CHD patients were female, the duration of hypertension of 10 -20 years, the duration of hypertension of 20 -30 years, diabetic history or dyslipidemia and therapeutic lifestyle change (TLC). The OR of these risk factors were 1.750 (95% CI: 1. 252 -2.445), 3.988 (95%CI: 1.951 -8.152), 2.158 (95%CI: 1.075-4.333), 3.026 (95%CI: 1.986-4.610), 2.166 (95% CI: 1.549 -3.030) and 0.493 (95%CI: 0.302 -0.805) respectively. The independent risk factors of achieving the blood glucose target for the elderly CHD patients were diabetic history, TLC, diuretics, calcium channel blocker ( CCB) and hypoglycemic drugs. The OR of these risk factors were 3. 191 (95% CI: 2. 259 - 4. 507), 0. 690 (95% CI: 0. 528 - 0. 902 ) , 1. 507 (95% CI:1.150-1.975), 0.718 (95%CI: 0.579 -0.890) and 0.477 (95%CI: 0.235 -0.969) respectively.Conclusion In the present survey, the achievement rates of blood pressure, serum lipids and blood glucose are low in the elderly CHD patients, especially in females. There has been a huge gap between the treatment guidelines and clinical practices in China. We should carry out different strategies according to different conditions to enhance the health and life quality for the elderly CHD patients.     

高尿酸血症与老年脑梗死的关系探讨

目的：讨论高尿酸血症（HUA）与老年脑梗死及其神经功能缺损程度的关系。方法选择2012年10月-2014年2月北京市回民医院（以下简称“我院”）110例老年急性脑梗死患者作为研究组,并选择同期我院56例健康体检者作为对照组。检测并比较两组血尿酸（UA）、低密度脂蛋白胆固醇（LDL-C）、血糖（Glu）、收缩压（SBP）、舒张压（DBP）水平,研究血UA水平与患者病情严重程度的关系。结果①研究组患者血浆UA、LDL-C、Glu水平[（343.65±70.15）μmol/L、（3.28±0.49）mmol/L、（6.45±1.55）mmol/L]均显著高于对照组[（259.55±74.58）μmol/L、（2.58±0.42）mmol/L、（5.92±1.34）mmol/L],差异有统计学意义（P〈0.05或〈0.01）。②多因素Logistic回归分析结果显示,血UA水平升高（OR=1.020,95%CI：1.011-1.030）、高血压（OR=1.206,95%CI：1.091-1.333）、糖尿病（OR=1.678,95%CI：1.052-2.676）和高LDL-C血症（OR=2.473,95%CI：1.252-3.676）是老年脑梗死的独立危险因素。③研究组中随着病情程度分层递增,血UA水平逐步增高,差异有高度统计学意义（〈0.01）。结论 HUA是老年脑梗死的独立、可干预的危险因素,并可提示老年脑梗死病情的严重程度。     

中青年高血压患者血压参数与左室结构的关系

资料与方法 选取2005年3月～2007年3月门诊患者及健康体检者,年龄≤50岁,符合WHO关于高血压的诊断标准,未服药或未规律服药,排除心脏瓣膜病、心肌病、肝肾功能损害等。按高血压类型分为单纯收缩期高血压（ISH）,单纯舒张期高血压（IDH）,及双期高血压（SDH）三组,ISH组选择收缩压〉140mmHg、舒张压〈90mmHg者30例,IDH组选择收缩压〈140mmHg、舒张压〉90mmHg者30例,SDH组选择收缩压〉160mmHg、舒张压〉90mmHg者30例。另选无运动员史的健康体检者30例作对照组。入选所有高血压患者以脉压〈50mmHg及脉压≥50mmHg。     

河南省某地区农村居民肥胖指标与血压及高血压的关系

目的:了解河南省农村居民不同肥胖指标与血压及高血压的关系。方法:2007年7月至2008年7月,采用随机整群抽样的方法抽取河南省某地区68个自然村18岁以上的常住居民共计20152人,进行肥胖和血压水平的横断面调查。结果:随着WHtR和BMI的增加,收缩压、舒张压、脉压和高血压患病率呈升高趋势;中心性肥胖者以上指标高于正常者(P<0.001)。BMI、WC和WHtR与收缩压、舒张压和脉压呈正相关关系(P均<0.001)。相对于BMI<18.5kg.m-2组,18.5kg.m-2～、24.0kg.m-2～和≥28.0kg.m-2组高血压患病的OR分别为1.6(95%CI:1.2～2.0)、2.2(95%CI:1.7～2.9)和3.6(95%CI:2.7～4.8);相对于正常者,中心性肥胖的OR为1.3(95%CI:1.1～1.4);相对于WHtR<0.47组,0.47～、0.52～和≥0.57组的OR分别为1.4(95%CI:1.3～1.6)、1.6(95%CI:1.3～1.8)和2.0(95%CI:1.7～2.4),P均<0.001。结论:河南省某地区农村居民肥胖指标与血压、脉压及高血压患病率之间存在密切联系,应控制全身性肥胖和中心性肥胖,从而防治高血压。     

中老年高血压患者216例脉压与冠心病危险性的相关分析

目的 :研究不同脉压时冠心病发病率的变化。方法 :回顾性分析了 2 1 6例中老年高血压病患者的脉压 ( PP)与冠心病发生的相关性。结果 :1冠心病组在年龄、高血压病程和冠心病危险因素 (吸烟、饮酒、糖尿病 )暴露比例上显著高于非冠心病组。2根据脉压 PP<5 0 mm Hg,5 0 mm Hg≤ PP<80 mm Hg,PP≥ 80 mm Hg 3组间经方差分析 ,SBP,DBP之间存在显著性差异 ( P<0 .0 1 )和 ( P<0 .0 5 ) ;而 MBP之间无差异 ( P>0 .0 5 )。随着 PP值增大 ,SBP逐渐增大 ,DBP逐渐降低。 3 3组间随着 PP值增大 ,冠心病的发生率随之增加 ,经卡方检验( P<0 .0 5 )。结论 :在中老年高血压病人中 ,随着脉压增大 ,SBP增大 ,DBP降低 ,冠心病的发病率呈显著增加趋势 ,PP与冠心病发生呈显著正相关。     

糖代谢异常人群中不同高血压亚型的心脑血管疾病风险

目的 因糖代谢异常人群的孤立性收缩期高血压(isolated systolic hypertension, ISH)、孤立性舒张期高血压(isolated diastolic hypertension, IDH)及收缩期和舒张期高血压(systolic and diastolic hypertension, SDH)相关的心脑血管疾病风险证据较少,所以本研究将探索不同高血压亚型的心脑血管疾病风险,为进一步改善识别高危人群提供科学依据。方法 本研究包括来自开滦社区队列研究的24 605例2006-2007年基线血压测量,没有服用高血压药物且没有心脑血管疾病病史的受试者。受试者根据基线血压水平分为8组：血压正常组[systolic blood pressure (SBP)<120 mmHg(1 mmHg=0.133 kPa)并且diastolic blood pressure (DBP)<80 mmHg)];血压高值组(120 mmHg≤SBP≤129 mmHg并且DBP<80 mmHg);Ⅰ期IDH组(SBP<130 mmHg并且80 mmHg≤DBP≤89 mm...     

Age-related differences in simultaneous interarm blood pressure measurements.

Simultaneous noninvasive blood pressure measurement were recorded bilaterally in 40 young and 40 elderly subjects. Overall interarm blood pressure (BP) differences for the elderly and young groups were similar, the absolute interarm differences being for systolic blood pressure (SBP) elderly: 4.2 mmHg (95% CI 3.1-5.3 mmHg); young 3.3 mmHg(2.6-4.1 mmHg); diastolic blood pressure (DBP) elderly 3.6 mmHg(2.8-4.4 mmHg), young 2.7 mmHg(2.0-3.3 mmHg). However, the range of interarm BP differences was wide. Four (10%) of the elderly had an interarm SBP difference > 10 mmHg compared to one (3%) of the young group. Interarm DBP differences > 8 mmHg were found in three (8%) of the elderly and in none of the young group. Although age does not affect mean interarm BP differences, clinically important interarm BP differences exist in both young and elderly subjects. Blood pressure should be measured in both arms of all patients at initial assessment to avoid potential problems with misclassification of blood pressure status.     

上海市南汇区中年居民BMI与血压水平的相关性研究

目的探讨体质量指数（body mass index,BMI）与人群血压水平的相关性,为心脑血管疾病危险因素控制提供参考。方法选择上海市南汇区某社区40～64岁人群共515名,进行问卷测量血压、身高、体质量等。按BMI值将其分为正常体质量组、超重组及肥胖组,对3组的血压及BMI分析比较,并对BMI与血压进行相关分析。结果高血压组的平均BMI及超重率与肥胖率高于对照组;女性BMI值对高血压的影响更明显（P〈0.01）。除男性收缩压外,不同BMI者,收缩压和舒张压的水平有显著性差异（P〈0.01）。女性收缩压与BMI的相关系数为0.221（P〈0.01）。男女舒张压与BMI相关性分别为r=0.141（P〈0.05）及r=0.180（P〈0.05）。结论40～46岁社区人群BMI对高血压及血压水平均有显著影响,BMI与血压的相关性女性高于男性,BMI与男性舒张压的相关性高于收缩压。     

Blood pressure control among Indians with hypertension: the I-Target survey

Hypertension, a major cardiovascular disease risk factor, is increasing in India. Though several studies have studied the prevalence and causes of hypertension in India, only few have examined the control of blood pressure (BP) among people with hypertension. The I-Target survey was carried out to assess the extent of BP control among Indian patients with hypertension receiving antihypertension medications. A total of 270 physicians from four zones of India included 3402 patients with hypertension who were undergoing treatment. They collected information on BP levels, current medication and presence of other risk factors, and determined the average systolic and diastolic BP in hypertensive patients. Of the study population, 1435 patients (42.2%) had diabetes and 787 (23.1%) had coronary artery disease (CAD). Overall, 70.5% patients did not reach target systolic BP (SBP) goal and 36.9% patients did not reach diastolic BP (DBP) goal. Only 27.3% patients had both SBP and DBP under control. Among patients with diabetes, 81.1% had uncontrolled SBP and 76.2% had uncontrolled DBP. In patients with CAD, 71.8% of SBP and 38.5% of DBP readings were outside the recommended target BP levels. Regardless of comorbidities-hypercholesterolaemia, myocardial infarct, metabolic syndrome, stroke, diabetic nephropathy or obesity--the average SBP and DBP were higher than target BP levels. Among patients with hypertension, control of BP to recommended targets was very poor, only to the extent of 27.3%. The average BP of hypertensive patients with comorbidities like diabetes and CAD was also higher than the BP goals recommended by international and local guidelines. Thus, there is an urgent need to increase awareness among patients with hypertension and to ensure that BP goals are achieved.     

肥胖高血压患者早期肾功能受损发生情况及影响因素研究

背景　肥胖高血压患者出现尿微量白蛋白（MAU）,除了肥胖本身这个因素外,其他相关的危险因素研究则较少。目的　探讨初诊肥胖高血压患者早期肾功能受损发生情况及其相关危险因素。方法　选择2015年12月-2017年12月在常德市第一人民医院门诊首次就诊的高血压患者456例,其中肥胖组111例,超重组210例,正常体质量组135例。比较三组患者一般资料、肾功能指标、诊室血压、动态血压,分析早期肾功能受损发生情况。然后将肥胖组患者依据尿微量白蛋白肌酐比值（ACR）分为MAU阳性组和阴性组,比较两组临床资料,并采用多因素Logistic回归分析肥胖患者发生MAU的影响因素。结果　肥胖、超重与体质量正常组患者性别、体质指数（BMI）、高密度脂蛋白胆固醇、三酰甘油、MAU阳性率、肌酐、尿酸、诊室收缩压和舒张压、24 h收缩压、白昼收缩压和舒张压、夜间收缩压比较,差异有统计学意义（P<0.05）。MAU阳性组肥胖患者的空腹血糖、诊室收缩压和舒张压、24 h收缩压和舒张压、白昼收缩压和舒张压、夜间收缩压和舒张压高于阴性组,夜间收缩压下降率低于阴性组,差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示,空腹血糖〔OR（95%CI）=8.289（2.221,30.936）〕、白昼收缩压〔OR（95%CI）=5.528（1.019,30.588）〕、夜间收缩压下降率〔OR（95%CI）=0.117（0.038,0.360）〕是肥胖高血压患者发生MAU的影响因素（P<0.05）。结论　肥胖高血压患者是早期肾功能损害的高危人群,空腹血糖、白昼收缩压和夜间收缩压下降率与肥胖高血压患者发生早期肾功能受损相关联。     

Effects of Outdoor Temperature on Blood Pressure in a Prospective Cohort of Northwest China

Objective The relationship between outdoor temperature and blood pressure(BP) has been inconclusive. We analyzed data from a prospective cohort study in northwestern China to investigate the effect of outdoor temperature on BP and effect modification by season.Methods A total of 32,710 individuals who participated in both the baseline survey and the first follow-up in 2011–2015 were included in the study. A linear mixed-effect model and generalized additive mixed model(GAMM) were applied to estimate the association between outdoor temperature and BP after adjusting for confounding variables.Results The mean differences in systolic blood pressure(SBP) and diastolic blood pressure(DBP)between summer and winter were 3.5 mm Hg and 2.75 mm Hg, respectively. After adjusting for individual characteristics, meteorological factors and air pollutants, a significant increase in SBP and DBP was observed for lag 06 day and lag 04 day, a 0.28 mm Hg(95% CI: 0.27–0.30) per 1 °C decrease in average temperature for SBP and a 0.16 mm Hg(95% CI: 0.15–0.17) per 1 °C decrease in average temperature for DBP, respectively. The effects of the average temperature on both SBP and DBP were stronger in summer than in other seasons. The effects of the average temperature on BP were also greater if individuals were older, male, overweight or obese, a smoker or drinker, or had cardiovascular diseases(CVDs), hypertension, and diabetes.Conclusions This study demonstrated a significant negative association between outdoor temperature and BP in a high-altitude environment of northwest China. Moreover, BP showed a significant seasonal variation. The association between BP and temperature differed by season and individuals' demographic characteristics(age, gender, BMI), unhealthy behaviors(smoking and alcohol consumption), and chronic disease status(CVDs, hypertension, and diabetes).     

动态血压监测评价国产缬沙坦治疗轻中度高血压的疗效

目的评价国产缬沙坦治疗轻中度原发性高血压的降压疗效和安全性。方法给予21例轻中度原发性高血压患者国产缬沙坦80mg/d口服,4周末诊室舒张压≥90mmHg(12.0kPa)者加量至160mg/d继续服用4周。每2周随访1次,记录诊室血压、心率及不良反应,服药前及治疗8周后进行动态血压监测及实验室检查。结果治疗8周后,诊室血压和24h动态血压均较治疗前降低(P<0.01),总有效率66.7%,心率较治疗前无显著变化。诊室收缩压/舒张压分别下降至16.95/11.52mmHg(2.25/1.53kPa),24h收缩压/舒张压分别下降至11.37/9.89mmHg(1.51/1.32kPa)。收缩压负荷/舒张压负荷分别下降至16.26/27.37。收缩压和舒张压的谷峰比值分别为65.15%和67.87%,正常血压昼夜节律不改变。不良反应轻微。结论国产缬沙坦80~160mg/d治疗轻中度原发性高血压安全有效。