正常高值血压人群动脉早期损害的评价

目的 探讨正常高值人群的动脉早期损害情况.方法 连续选取2009年10月至2010年5月于大连医科大学附属第一医院体检中心体检的健康人群958人为研究对象,分为正常血压组(n=859)和正常高值血压组(n=99).记录两组性别、年龄、身高、体质量、腰围、血压、心率、空腹血糖、血脂、血清肌酐、尿酸,计算体质量指数、肌酐清除率,测定桡动脉增强指数.并对两组各项指标进行比较.结果 正常高值血压组的体质量、体质量指数、收缩压、舒张压、空腹血糖、总胆固醇、低密度脂蛋白胆固醇、尿酸及桡动脉增强指数高于正常血压组[(71.56±10.27)kg vs.(66.72±12.34)kg、(25.38±2.96)kg/m2 vs.(23.74±3.33)kg/m2、(132.65±4.27)mmHg vs.(114.53±8.73)mmHg、(81.61±6.54)mmHg vs.(70.61±7.32)mmHg、(5.38±0.65)mmol/L vs.(5.21±0.60)mmol/L、(198.73±38.80)mg/dL vs.(186.20±34.51)mg/dL、(118.64±22.71)vs.(110.43±21.17)mg/dL、(296.32±89.41)μmol/L vs.(270.63±92.39)μmol/L、(79.39±12.91)% vs.(74.22±11.93)%;均P<0.05].桡动脉增强指数与舒张压、总胆固醇呈正相关(r值分别为0.398、0.244;均P<0.05),与尿酸呈负相关(r=-0.293;P<0.05). 结论 正常高值血压人群已存在早期动脉损害,且该组人群代谢异常较正常血压组更常见.

Evaluation of early arterial damage in high-normal blood pressure population by augmentation index

Objective To appraise the vascular damage in high-normal blood pressure (HNBP) population by radial augmentation index adjusted to a heart rate of 75 beats/min (rAI75).Methods Totally 958 subjects were recruited and classified into normal blood pressure group (NBP, n=859) and HNBP group (n=99).Background data, including weight, height, body mass index (BMI), waist circumstance (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), creatinine (Cr), and urea acid (UA) were collected.rAI75 was conducted in all subjects by tonometry according to the standard protocol.Results There were no significant differences in gender, age, height, HR, TG, HDL-C, clearance of Cr (CCr) between NBP group and HNBP group.But the weight, BMI, SBP, DBP, FPG, TC, LDL-C, UA, and rAI75 in HNBP group were significantly higher than NBP group [(71.56±10.27) vs.(66.72±12.34) kg, (25.38±2.96) vs.(23.74±3.33) kg/m2, (132.65±4.27) vs.(114.53±8.73) mmHg, (81.61±6.54) vs.(70.61±7.32) mmHg, (5.38±0.65) vs.(5.21±0.60) mmol/L, (198.73±38.80) vs.(186.20±34.51) mg/dL, (118.64±22.71) vs.(110.43±21.17) mg/dL, (296.32±89.41) vs.(270.63±92.39) μmol/L, (79.39±12.91) vs.(74.22±11.93)%,all P<0.05].rAI75 was positively correlated with DBP, TC and UA (r=0.398, 0.244, respectively, all P<0.05), and negatively correlated with UA (r=-0.293, P<0.05).Conclusion The arterial stiffness and metabolic problem in HBNP group are significantly increased compared to NBP group.Medical interventions, at least lifestyle interventions are needed in this special population.