高血压患者坐位和卧位血压测量值的比较

目的观察高血压患者坐位和卧位血压测量值的差别,分析性别、年龄、体重指数(BMI)、坐位血压和降压药物分别与坐、卧位收缩压(SBP)或舒张压(DBP)差别的关系。方法高血压患者1487例,采用台式水银血压计柯氏音听诊法分别进行先坐位后卧位两种体位血压测量,同时进行身高和体重的测量,并行年龄段分组,分别进行比较。结果卧位测量的血压值显著高于坐位测量的血压值,卧位SBP增高(2.9±7.8)mm Hg,DBP增高(0.9±5.4)mm Hg。女性高血压患者坐位和卧位DBP测量值的差别高于男性(P<0.01)。在各年龄段,卧位SBP增高以30~39岁和80岁以上的年龄组明显,分别增高(3.6±6.8)mm Hg,(5.3±7.9)mm Hg。而DBP在30~59岁年龄组坐位和卧位血压测量值差异无统计学意义(P>0.05),从60岁开始,卧位DBP显著高于坐位DBP(P<0.01),以80岁以上组明显,增高(2.5±4.6)mm Hg。坐、卧位SBP和DBP血压值的差别与相应的坐位血压呈负相关关系(SBP:r=-0.31;DBP:r=-0.39。均P<0.01)。治疗组卧位SBP比坐位增高(3.5±8.1)mm Hg,DBP增高(1.5±5.0)mm Hg,坐、卧位SBP和DBP血压值的差别均高于非治疗组(P<0.05)。多元回归分析结果显示,对坐、卧位SBP差别有影响的自变量是年龄;对坐、卧位DBP差别有影响的自变量是性别、年龄,而BMI对坐位和卧位血压测量值没有影响。结论高血压患者坐、卧位血压测量值是不同的,其不同既存在性别的差异,也与年龄、坐位血压相关;而且与所服用的降压药物也可能存在一定的关系。

Comparison of sitting and supine blood pressure in hypertensive patients

Objective To compare the differences of sitting and supine blood pressures in hypertensive patients and to explore the possible factors.Methods Supine blood pressure was measured after sitting blood pressure measuremert in 1487 hypertensive patients,using standard mercury sphygmomanometer.Clinical characteristics and medication were also recorded.Results Both systolic and diastolic blood pressures were significantly higher in supine position than in sitting position by(2.9±7.8)mm Hg and(0.9±5.4)mm Hg respectively,P<0.01].The increment of the blood pressure from sitting to supine position was more pronounced in female than in male,particularly diastolic blood pressure(P<0.01).Greater increment in systolic pressure from sitting to supine position was found in 30-39 years oldand above 80 years old groups.The differences between sitting and supine diastolic blood pressures were not significant in patients with ages between 30 and 60 years,but significant in patients more than in 60 years old(P<0.01).The greatest increment in diastolic pressure from sitting to supine position was found in patients above 80 years old.Blood pressure increment from sitting to supine position was inversely correlated with sitting blood pressure(P<0.01).This increment was more pronounced in treated hypertensive patients than untreated ones(P<0.05).Multivariate regression analysis showed that age was an independent factor influencing systolic pressure increment(P<0.01),while sex and age were independent predictors for diastolic blood pressure increment(P<0.01). Conclusions Sitting and supine blood pressures are different in hypertensive patients.Factors as sex,age,sitting blood pressure and antihypertensive medication can influence sitting-supine blood pressure difference.