正常高值血压42例心血管病危险因素分析

目的探讨正常高值血压患者的心血管病危险因素。方法根据《中国高血压防治指南(2005年修订版)》选择正常高值血压组42例及理想血压组50例,测量腰围、身高、体质量、坐位血压,计算体质量指数(BMI)、腰臀围比(WHR);测定空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、尿液微量白蛋白(MAU);并进行24 h动态心电图(Holter)、24 h动态血压(ABPM)监测。结果正常高值血压组与理想血压组相比,UA和MAU含量分别为(337.48±70.58)μmol/L比(257.63±69.42)μmol/L;(3.84±1.62)mg/L比(3.09±0.62)mg/L,差异有统计学意义(P<0.01)。正常高值血压组的WHR(0.83±0.08)与理想血压组(0.73±0.04)比较,差异有统计学意义(P<0.01)。两组的心率变异性(HRV)时域和频域参数比较差异有统计学意义(P<0.05)。两组的24 h收缩压变异系数(24 hSSD)分别为(17.3±2.3)%和(13.9±1.8)%;24 h舒张压变异系数(24hDSD)分别为(13.2±1.7)%和(10.3±1.7)%;非杓型血压的比例分别为26%和8%;收缩压负荷率(SBP-L)分别为(34±21)%和(12±10)%;舒张压负荷率(DBP-L)分别为(32±20)%和(11±9)%;差异有统计学意义(P<0.01)。比较两组的BMI、FPG、CHO、TG、HDL-C、和LDL-C差异无统计学意义(P>0.05)。结论与理想血压组比较,正常高值血压组的UA、MAU明显升高;迷走神经张力下降;血压变异性(BPV)、血压负荷和非杓型血压比例增高。

Analysis of cardiovascular disease risk factors in 42 cases with high-normal blood pressure

Objective To study the risk factors of cardiovascular disease in 42 patients with the high-normal pressure. Methods According to "hypertension prevention and cure guideline of China 2005",42 cases of high-normal blood pressure and 50 cases of normal pressure were selected.The waistline,body height,body weight,sitting blood pressure,body mass index(BMI),waist to hip ratio(WHR),fasting plasma glucose(FPG),total cholesterol(CHO),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),uricacid(UA) and microalbuminuria(MAU) were measured.24h Holter and 24h ABPM were observed. Results The comparison between high-normal pressure group and normal pressure group showed that the UA were(337.48±70.58)μmol/L and (257.63±69.42)μmol/L,respectively(P<0.01);the MAU were(3.84±1.62)mg/L and(3.09±0.62)mg/L,respectively,the difference showed statistical significance(P<0.01).The WHR in the high-normal pressure group(0.83±0.08) was compared with in the normal pressure group(0.73±0.04),the difference showed statistical significance(P<0.01).The parameters of HRV between time domain and frequency domain had statistical difference(P<0.05).24hSSD in two groups were(17.3±2.3)% and(13.2±1.7)%,24hDSD were(13.9±1.8)% and(10.3±1.7)%,respectively;the proportion of non-dipper blood pressure were 26% and 8%(P<0.01);SBP-L were(34±21)% and(12±10)%,DBP-L were(32±20)% and(11±9)% respectively,the difference showed statistical significance(P<0.01).The differences of BMI,FPG,CHO,TG,HDL-C and LDL-C between two groups showed no statistical significance(P>0.05). Conclusion Compared with normal blood pressure group,UA and MAU in the high-normal blood pressure group significantly increased;vagal tone decreased;BPV,blood pressure load and non-dipper Blood pressure proportion all increased.