高血压病血压昼夜节律与心肌缺血的关系

目的 探讨高血压病患者血压昼夜节律改变与心肌缺血之间的关系及临床意义。方法对90例高血压病患者,根据动态心电图上有无心肌缺血(MI)分为MI组(40例)和无MI组(50例),并与20例健康体检者进行对照,观察3组的动态血压变化,同时分析血压昼夜节律正常组和异常组的心肌缺血的发生情况。结果 高血压病伴有MI的患者中,除dSBP、24hDBPL、dSBPL、dDBPL与无MI组比较无统计学差异外,其余各项动态血压指标均明显高于无MI组(P<0.01);高血压病血压昼夜节律异常组发生MI者明显高于血压昼夜节律正常组(P<0.05)。结论 高血压病患者中伴有血压昼夜节律异常者更易导致心肌缺血的发生。对高血压病患者的治疗,除积极控制血压外,还应注意检测和逆转异常的昼夜血压节律,对减少心肌缺血的发生和靶器官损害具有重要意义。

Correlation between abnormal circadian rhythm of blood pressure and myocardial ischemia in essential hypertention

Objective To explore the relationship between abnormal circadian rhythm of blood pressure and myocardial ischemia in patients with essential hypertention. Methods 90 cases of essential hypertention was divided into myocardial ischemia (MI) group and no myocardial ischemia ( no-MI) group. Ambulatory electrocardiogram mornitoring was performed in essential hypertention cases (MI group and no-MI group) and other 20 healthy subjects(control group) . The variations of ambulatory BP parameters were compared among these three groups. The incidence rate of MI was also evaluated in essential hypertention cases with normal or abnormal circadian rhythm of blood pressure. Results The values of majority ambulatory BP parameters in essential hypertention patients with MI were higher than that in ones without MI(P< 0.01). The incidence rate of MI in essential hypertention cases with abnormal circadian rhythm of blood pressure was higher than that in ones with normal circadian rhythm of blood pressure (P < 0.05) . Conclusion It is easier for essential hypertention cases with abnormal circadian rhythm of blood pressure to get MI. For treatment of essential hypertention cases, it is important to detect and reverse the abnormal circadian rhythm of BP in order to reduce incidence rate of MI and target organ damage.