Postoperative course of blood pressure and plasma renin activity in patients with renovascular hypertension.

Thirty patients with renovascular hypertension were treated surgically, and they were divided into two groups according to the kinds of operations they received; nephrectomized group (group A) and revascularized group (group B). Postoperative blood pressure was followed periodically in each patient of two groups. In all patients with an excellent result (diastolic pressure of 90 mmHg or lower without antihypertensive therapy), blood pressure returned to normal within 30 postoperative days. Normal blood pressures were obtained within 3 weeks in eighty-four per cent of them. The normalization of blood pressure following operation was more rapid in group B than in A. The postoperative plasma renin activity (PRA) was determined serially in 10 patients. PRA became normal in 9 within 3 days and in one within 7 postoperative days. The restoration of PRA preceded the normalization of blood pressure. The normalization of PRA was quicker in group A than in B. It is likely that the renal antihypertensive mechanism, suppressed in the ischemic kidney and set again in motion by revascularization, mainly causes this difference in the postoperative changes in PRA and blood pressure between the two groups. It may be concluded that these findings are suggestive of an important role of impaired renal antihypertensive function in the maintenance of high blood pressure in chronic renovascular hypertension in man.     

血压测量对静脉采血后止血效果的影响

由于人们的生活水平不断提高，保健的需求也与日俱增。做体检又与患病就诊的程序有很大的不同，是一种具有很强的连贯性，一般都在2h～3h完成整个体检过程。静脉采血在身体检查中是必不可少的操作。在体检过程中发现，测血压时体检者静脉穿刺部位出血。现分析如下。     

血压测量对静脉采血后止血效果的影响

由于人们的生活水平不断提高,保健的需求也与日俱增。做体检又与患病就诊的程序有很大的不同,是一种具有很强的连贯性,一般都在2h～3h完成整个体检过程。静脉采血在身体检查中是必不可少的操作。在体检过程中发现,测血压时体检者静脉穿刺部位出血。现分析如下。1临床资料7位体健者在抽完静脉血后,穿刺部位经局部压迫止血后无出血,在20min内进行血压测量的同时,穿刺的皮下出现出血的情况。均在40岁以上,最大76岁,有高血压病史3人,2人有冠心病史同时服用小剂量的阿司匹林。均为右臂肘正中的静脉采血,测量血压的部位也是右上肢。随后发现,有些3…     

肾性高血压与原发性高血压患者动态血压观察

目的：观察肾性高血压与原发性高血压患者动态血压情况及节律变化。方法：采用美国无创性便携式动态血压监测仪,测试时间８～９ Ａｍ 至次日８～９ Ａｍ,测量间隔为３０ ｍｉｎ。结果：两组患者的２４ ｈ ＳＢＰ、２４ ｈ ＤＢＰ、ｄ ＳＢＰ、ｄ ＤＢＰ及血压负荷无明显差异（ Ｐ＞ ０．０５）。肾性高血压组ｎ ＳＢＰ、ｎ ＤＢＰ显著高于原发性高血压组（Ｐ＜ ０．００１）,原发性高血压组夜间ｎ ＳＢＰ、ｎ ＤＢＰ均低于白昼血压（ Ｐ值均＜ ０．０１）,肾性高血压组的夜间ｎ ＳＢＰ、ｎＤＢＰ与白昼血压无明显差异（Ｐ＞ ０．０５）。肾性高血压组ＳＢＰ、ＤＢＰ夜间下降百分率＜１０％ 者,明显高于原发性高血压组（分别为４８％ 、６０％ 及３０％ 、２２．５％ ,Ｐ＜ ０．０５） 。结论：原发性高血压患者的动态血压存在着昼夜节律,肾性高血压患者节律性消失。     

厄贝沙坦及倍他乐克对高血压患者动态血压的影响

目的观察厄贝沙坦及倍他乐克对高血压患者动态血压的影响。方法选择80例原发性高血压患者,分成厄贝沙坦组及倍他乐克组,每组40例。治疗前及治疗后3个月行24h动态血压检测,观察血压控制情况。结果治疗前两组患者血压无显著差异,经治疗后两组患者血压都有显著性下降,两组在治疗后24h夜均舒张压没有显著差异性,其余24h收缩压、24h舒张压、日间收缩压和舒张压、夜间收缩压均有显著差异性,厄贝沙坦组血压下降更明显。结论厄贝沙坦和倍他乐克对原发性高血压降压疗效均明显,厄贝沙坦组血压下降效果更佳。     

Study for the influence of clinical behavior on blood pressure for patients after cardiac surgery

目的 探讨6项临床行为对心脏术后患者血压的影响,以指导临床护理.方法 应用飞利浦MP60心电监护仪动态测量56例心脏术后患者在临床行为(疼痛、深呼吸、剧烈咳嗽或吸痰、排便、饱餐、寒冷)发生前后的血压值,并用医用秒表记录血压波动持续时间,应用SPSS17.0统计软件对血压资料进行配对t检验.结果 6项日常临床行为中,显著影响该组人群收缩压的因素有:疼痛、剧烈咳嗽或吸痰、用力排便、饱餐及寒冷;除深呼吸及饱餐外,其他4项临床行为与舒张压有关(P＜0.05);且不同行为引起的血压波动持续时间各不相同.结论 部分临床行为可显著影响心脏术后患者的血压值,护理时应尽力避免并应对这些行为改变所引起的血压波动.     

临床行为对心脏术后患者血压影响的研究

目的探讨6项临床行为对心脏术后患者血压的影响,以指导临床护理。方法应用飞利浦MP 60心电监护仪动态测量56例心脏术后患者在临床行为(疼痛、深呼吸、剧烈咳嗽或吸痰、排便、饱餐、寒冷)发生前后的血压值,并用医用秒表记录血压波动持续时间,应用SPSS 17.0统计软件对血压资料进行配对t检验。结果6项日常临床行为中,显著影响该组人群收缩压的因素有:疼痛、剧烈咳嗽或吸痰、用力排便、饱餐及寒冷;除深呼吸及饱餐外,其他4项临床行为与舒张压有关(P<0.05);且不同行为引起的血压波动持续时间各不相同。结论部分临床行为可显著影响心脏术后患者的血压值,护理时应尽力避免并应对这些行为改变所引起的血压波动。     

体位对肱动脉间接血压测量值的影响

[目的 ]体位及肱动脉位置变化对肱动脉间接血压测量结果的影响。 [方法 ]采用HEM— 75uzzy型智能电子血压计 ,对随机抽取的 3 0名健康女生测量其 5种体位的肱动脉血压 ,并进行自身配对t检验。[结果 ]坐位时左右上肢肱动脉收缩压有差异 (P <0 .0 1) ;肱动脉位置高于心脏水平时 ,收缩压、舒张压均低于肱动脉与心脏在同一水平时 (P <0 .0 1) ;坐位时肱动脉收缩压低于卧位时 (P <0 .0 1)。 [结论 ]不同体位及不同上肢对肱动脉血压测量结果有一定影响 ,进行个体血压监测比较时应考虑此影响 ,为保证坐位血压测量的准确性 ,须注意保持所测手臂的肱动脉与心脏在同一水平。     

肠道准备对腹腔镜手术病人术前血糖和血压水平的影响

[目的]探讨腹腔镜手术病人低血糖和低血压发生情况，以指导护士对病人术前肠道准备的护理。[方法]在病人入院次日06：00（空腹血糖）、术前22：00和术晨06：00分别测血压和血糖。对3次结果进行统计学分析比较。[结果]术前晚和术晨血糖值均较入院时明显降低（P〈0．01），其中术前晚和术晨有4例出现低血糖，术前晚与术晨血糖比较无统计学意义（P〉0．05）；而血压变化在本次研究中无统计学意义（P〉0．05）。[结论]腹腔镜手术前病人在肠道准备后术前晚和术晨血糖值均低于入院时水平。提醒护士护理时应注意。     

肠道准备对腹腔镜手术病人术前血糖和血压水平的影响

[目的]探讨腹腔镜手术病人低血糖和低血压发生情况,以指导护士对病人术前肠道准备的护理。[方法]在病人入院次日06:00(空腹血糖)、术前22:00和术晨06:00分别测血压和血糖,对3次结果进行统计学分析比较。[结果]术前晚和术晨血糖值均较入院时明显降低(P<0.01),其中术前晚和术晨有4例出现低血糖,术前晚与术晨血糖比较无统计学意义(P>0.05);而血压变化在本次研究中无统计学意义(P>0.05)。[结论]腹腔镜手术前病人在肠道准备后术前晚和术晨血糖值均低于入院时水平,提醒护士护理时应注意。     

联合应用波依定和依那普利对单纯收缩期高血压患者动态血压的影响

目的:探讨联合应用波依定和依那普利对单纯收缩期高血压患者动态血压的影响。方法:将120例单纯收缩期高血压患者随机分为3组:波依定组(35例),依那普利组(40例),联合治疗组(45例)。波依定组5 mg、依那普利组10 mg,联合治疗组波依定5 mg 依那普利10 mg 1次/d,共6周。用药前后进行24 h动态血压监测。结果:3组药物治疗第6周末24 h动态血压监测发现,24 h平均收缩压、脉压、舒张压、平均动脉压均较服药前明显降低(P<0.01)。单药波依定组与依那普利组对全天平均收缩压下降幅度分别为(24.6±13.5)mmHg和(23.6±7.3)mmHg,组间差异无统计学意义(P>0.05)。而联合治疗组对全天平均收缩压下降幅度为(31.8±15.4)mmHg,与两单药治疗组相比均有明显降低(P<0.01)。联合组的有效率和达标率较单药治疗组有明显提高(P<0.01),但单药组间差异无统计学意义(P>0.05)。结论:联合应用波依定及依那普利较单独应用波依定与依那普利对单纯收缩期高血压疗效好且安全性好。     

社区健康教育对原发性高血压患者的血压控制影响研究

目的:探讨社区健康教育对原发性高血压患者血压控制的影响。方法:将186例原发性高血压患者随机分成干预组和对照组,各98例,所有患者均接受药物治疗,其中干预组除接受药物治疗外还进行高血压防治的健康教育,对照组仅单纯接受药物治疗。观察并比较两组的血压水平和控制状况。结果:与对照组相比,干预组的复查率、控制率和治疗率均更高,两组间的差异都有统计学意义(P0.05,P0.01)。两组的收缩压与舒张压均有不同程度的降低。与对照组相比,干预组的血压值更低,且两组间的差异也有显著性差异(P0.01)。结论:社区健康教育可以有效提高患者对高血压病知晓率、治疗率、控制率,使血压保持在合理水平。     

Impact of initial blood pressure on antihypertensive response in patients with acute hypertension

Introduction

The effect profile of differing antihypertensive agents is well studied, but minimal data regarding the interaction between hemodynamic response and presenting blood pressure (BP) exist.

Hypothesis

Achievement of target BP is less likely in patients with higher initial BPs.

Methods

This is a substudy of the multicenter safety and efficacy Evaluation of intravenous Cardene (nicardipine) and Labetalol Use in the Emergency department (CLUE) trial that randomized patients to Food and Drug Administration–recommended intravenous dosing of nicardipine or labetalol to reach a physician predefined systolic BP (SBP) and target range (TR) of ± 20 mm Hg within 30 minutes. The proportion achieving TR was assessed as a function of initial SBP, and dichotomized comparisons were made using median SBP. Likelihood of a final BP within TR was modeled using logistic regression with forced inclusion of initial BP as a categorical variable.

Results

A total 223 patients were enrolled; 115 (51.6%) had an initial SBP greater than the median 202 mm Hg. The median SBP (interquartile range) of the high BP group was 218 (210-228) mm Hg vs the low BP group 190 (182-197) mm Hg (P < 0.0001). No groupwise differences existed except that the high group had higher mean (SD) serum creatinine level at baseline (3.1 [3.9] vs 1.9 [2.3], P = .008). The proportion of patients achieving SBP within TR at 30 minutes did not differ (85.2% [98 of 115] vs 88.9% [96 of 108], P = .42). Randomization to nicardipine (odds ratio = 2.85; 95% confidence interval, 1.16-7.01), but not initial SBP (odds ratio = 0.60; 95% confidence interval, 0.25-1.44), was associated with achievement of target SBP at 30 minutes.

Conclusion

Initial SBP is not a predictor of the ability to achieve a prespecified target range SBP within 30 minutes.     

改变不良生活习惯对高血压患者血压控制的影响

BACKGROUND:Livinghabitswithsmoking,obesityandrestishighriskfactorofhypertension.Everyhypertensionpatientin-cludingthosereceivingdrugtherapyshouldchangelivinghabit.Whenlivinghabitameliorate,decompressionfunctioncanbeob-servedandriskfactorsofhypertensiondecrease.OBJECTIVE:ToinvestigateInfluenceofchangingbadlivinghabitsonbloodpressurecontrolofhypertensionpatients.UNIT:DepartmentofCardiologyInternalMedicineofSecondPeople'sHospitalofWenzhou.SUBJECTS:173hypertensioncasesfromSeptember…     

随访干预对原发性高血压患者血压控制的影响

目的探讨随访干预对原发性高血压患者血压控制效果的影响。方法将2007年1月～2008年6月住院接受治疗的120例原发性高血压出院患者,按出院顺序分为干预组和对照组,各60例。干预组出院后进行6个月的随访干预,对患者生活行为方式进行指导;对照组出院后未予主动随访。出院6个月后评价两组生活行为方式、血压控制情况。结果出院6个月后干预组生活行为方式、血压控制效果显著优于对照组（P〈0.01）。结论随访干预可改善原发性高血压患者的生活行为方式,提高血压控制效果。     

Influence of changing bad living habits on blood pressure control of hypertension patients

Living habits with smoking,obesity and rest is high risk factor of hypertension.Every hypertension patient including those receiving drug therapy should change living habit.When living habit ameliorate,decompression function can be observed and risk factors of hypertension decrease.OBJECTIVE:To investigate Influence of changing bad living habits on blood pressure control of hypertension patients.UNIT:Department of Cardiology Internal Medicine of Second People‘s Hospital of Wenzhou.SUBJECTS:173 hypertension cases from September 1999 to June 2001,who accord with WHO diagnosis criteria issued 1999,including 129 males and 44 females,age 32-93,average age 67.INTERVENTION:Except for routine drug therapy,all the patients received health education,which focus on changing bad living habits,including:(1)Mental instruction:Some studies showed that modd of patients with hypertension was unstable,interpersonal relationship was sensitive or combined with anxiety,depression and paranoid.To this kind of patients,we adopted mental dredging,relaxing therapy,listening music,setting up their insterestings,et al,to change their mood,encourage patients to actively take part in all kinds of beneficial activities,keep calm,avoid exiting of mood,train self-control ability and keep good mental state.(2)Guide diet:restrict salt,high cholesterol,high fat diet and supply proper potassium,calcium and magnesium.Everyday intake of sodium should be less than 6g,fried foods and visceral of animal should be reduced,fruits containing more potassium such as orange,banana were eaten to control hypertension.Diets should contain vitamins,superior protein,calcium,Mg such as milk,fishes,musroom,vegetables,fruits.vitamins could promote metabolism of lipoids,especially that vitamin C could decrease catelone level.Ca,Mg also did good to decreasing of blood pressure.(3) Control weight:45 cases combined with obesity control weight.(4)Stop smoking and drinking.(5)Construct good living habit,take media and low strength exercise such as walk,jog,riding bicycle and gymnastics.Every patient take exercises 3-5 times every week with about half an hour for each time.RESULT:In these 173 cases,157 cases master self-care knowledge and health living habit and BP was under control.BP of 59 cases were fluctuating,after psychic nurse and removal of bad habits,BP was well controlled.CONCLUSION:Changing bad living habits play important function on blood pressure control of hypertension patients.     

老年单纯收缩期高血压患者的血压对颈动脉粥样硬化的影响

目的探讨老年单纯收缩期高血压对颈动脉粥样硬化的影响。方法上海市第二人民医院住院的老年高血压患者90例,其中单纯收缩期高血压患者45例,非单纯收缩期高血压患者45例,均做颈动脉超声检测,比较2组颈动脉粥样硬化发生的情况。结果老年单纯收缩期高血压患者颈动脉内膜中层增厚及粥样斑块的发生率与老年非单纯收缩期高血压患者相比更高,差异有统计学意义（P〈0.05）,提示前者病变更加严重。结论老年病患者的收缩压是比舒张压更强的致动脉粥样硬化的预测因子。