动态血压监测与高血压病预后的关系

目的 :探讨动态血压 (ABP)及偶测血压 (CBP)与高血压预后的关系。方法 :2 2 0例原发性高血压患者入选时分别测量基础状态下ABP及CBP、并根据白昼舒张压水平分为高、中、低 3个亚组 (HL、ML、LL) ,然后长期随访观察与高血压病相关的心脑血管“事件”。结果 :平均随访 38个月 ,发生各类“事件”者 2 6例 ,单因素分析表明 :“事件”组各项ABP参数明显高于“非事件”组 (P <0 0 5～ 0 0 1) ,而 2组CBP间无显著差异 (P >0 0 5 )。LL、ML、HL 3个亚组中“事件”发生率分别为 2例 10 0人年、3 4例 10 0人年及 6 3例 10 0人年。多因素分析显示 :SBP节律、夜间SBP水平及总胆固醇 (CT)水平为高血压患者“事件”发生的独立危险因素 ,分别为RR =3 0 8、RR =1.2 6、RR =1.4 9(P <0 0 5～ 0 0 1)。结论 :ABP在判断高血压预后方面较CBP更具有临床意义 ,较高的ABP水平提示不良的预后 ,SBP节律、夜间SBP水平是预测高血压患者心脑血管“事件”及肾脏受损的独立危险因素

The prognostic value of ambulatory blood pressure monitoring in essential hypertension

Objective:To investigate the prognostic value of ambulatory blood pressure (ABP)in essential hypertension.Method:Two hundred and twenty essential hypertensive patients were selected,casual blood pressure(CBP)and ABP were measured at the time of entrance.All subjects were divided into three subgroups(LL,ML and HL)according to the daytime diastolic blood pressure.The cardiovascular or cerebrovascular events were studied by long term follow|up.Result:A 180 cases of follow|up were studies.It had an average of 38 month 26 patients had events.ABP parameters of the events group were higher compare to the uneventful group( P <0 05～0 01),but the casual blood pressure(CBP)value had no significant difference between these two groups( P >0 05),the event rate was 2.2 per 100 patient|years,3.4 per 100 patient|years and 6.3 per 100 patient|years in LL.ML and HL respectively,significant difference in LL vs HL( P <0 05).Logistic multivariate analysis showed that SBP curve,nighttime SBP and serum total cholesterol were the independent risk factors of the events.Conclusion:higher value of ABP indicates a poor prognosis in hypertension,SBP curve and nighttime SBP level are the major independent risk factors for cardiovascular and cerebrovascular events in severe hypertension.