老年高血压患者7d家庭自测收缩压变异性与血管内皮功能的相关性

目的：探讨老年原发性高血压患者7 d 家庭自测血压变异性与血管内皮之间的相关性。方法对来自于健康体检中心体检的142例老年原发性高血压患者进行7 d 家庭自测血压监测及内皮细胞依赖性血管舒张功能（FMD）和内皮非依赖性血管舒张功能（NMD）检测。根据7 d 家庭自测血压变异性（用标准差表示）的三分位，将所有患者分为低变异性组、中变异性组及高变异性组3组。结果高变异性组 FMD 和 NMD 明显低于中及低变异性组，中变异性组明显低于低变异性组，P ＜0．05。FMD 及 NMD 与收缩压变异性（r 分别为－0．635及－0．448，P 均＜0．001）、舒张压变异性（r 分别为－0．187及－0．186，P 均＜0．001）呈负相关。多元线性回归分析显示，在用家庭自测平均收缩压及家庭自测平均舒张压进行校正后，收缩压变异性仍与 FMD 及 NMD 呈显著负相关。结论家庭自测血压变异增高可能是影响血管内皮功能失调的重要因素。

Relationship between variability of seven-dayself-measured blood pressure at home and vascular endothelial function in elderly hypertensive patients

Objective To investigate the relationship between variability of 7-day self-measured blood pressure (BP) at home and vascular endothelial function in elderly hypertensive patients.Methods Seven-consecutive-day self-measured blood pressure monitoring at home, brachial artery flow-mediated dilation (FMD) and nitroglycerin-mediated vasodilatation (NMD) were performed in 142 elderly essential hypertensive patients. Variability of self-measured blood pressure at home was assessed by the standard deviations (SDs) of the daily BP average of the last 6 consecutive days. Based on the level of SD of the daily systolic blood pressure (SBP) average, subjects were categorized into three groups:low home SBP variability group (low group), middle home SBP variability group (middle group), and high home SBP variability group (high group).Results FMD and NMD in high group were significantly lower than those in low and middle group (P < 0.05). FMD and NMD in middle group were markedly lower than those in low group (P < 0.05). Both FMD and NMD were negatively correlated with SD of self-measured SBP (r = -0.635 and -0.448, P < 0.001, respectively) and DBP (r = -0.187 and -0.186, P < 0.001, respectively).Results After adjusted with self-measured mean SBP and DBP at home and all other covariants, SD of SBP was still negatively correlated with FMD and NMD. Conclusions Excessive variability of self-measured blood pressure at home may be one of the important risk factors for vascular endothelial dysfunction.