高血压患者血压晨峰与急性冠状动脉事件的关系

目的探讨高血压患者血压晨峰与急性冠状动脉事件的相关性。方法选择186例高血压患者采用动态血压监测仪记录24 h血压。血压晨峰值≥32.6 mm Hg(1 mm Hg=0.133 kPa)患者为晨峰组(42例),血压晨峰值32.6 mm Hg为非晨峰组(144例),并对患者进行3年随访。患者同时具备胸痛、心电图动态变化或心肌酶学变化为急性冠状动脉事件(不稳定性心绞痛、急性心肌梗死)诊断标准。比较2组年龄、动态血压参数、急性冠状动脉事件发生率。结果与非晨峰组比较,晨峰组患者血压晨峰值、清晨动脉压、急性冠状动脉事件发生率均明显升高,差异有统计学意义(P0.05,P0.01);晨峰组24 h平均动脉压、清晨脉压虽高于非晨峰组,但差异无统计学意义(P0.05)。晨峰组患者血压晨峰值与急性冠状动脉事件发生率呈正相关(r=0.9),非晨峰组患者血压晨峰值与急性冠状动脉事件发生率无相关性(r=0.3)。结论高血压患者血压晨峰与急性冠状动脉事件发生密切相关,可能是冠状动脉事件的独立危险因素。

Relationship between morning blood pressure surge and acute coronary events in hypertension patients

Objective To investigate the relationship between morning blood pressure surge (MBPS)and acute coronary events(ACE) in hypertension patients.Methods Ambulatory blood pressure monitoring was done in 186 patients with hypertension.The patients were classified as the surge group (n= 42) and the non-surge group (n = 144) based on MBPS.They will be followed up for 3 years.ACE (unstable angina,acute myocardial infarction) was diagnosed by chest ache,ambulatory ECG and the change of myocardial enzymes.Age,ambulatory blood pressure monitoring and the rate of ACE were compared between the two groups.Results The MBPS, morning blood pressure and the rate of ACE in surge group were significantly higher than those in non-surge group (P < 0.05 ,P < 0.01).The 24 h mean arterial pressure and morning pulse pressure in surge group were not significantly higher than those in non-surge group (P >0.05). There was positive correlation between the rate of ACE and MBPS in surge group,and not in non-surge group.Conclusion There is close relation between the rate of ACE and MBPS in hypertension patients.MBPS may be an independent risk factor for ACE in hypertension patients.