青壮年高血压病的临床研究

目的研究青壮年高血压病(EH)患者的临床特点。方法按1999年中国高血压联盟制定的《中国高血压防治指南》标准,选择年龄25～44岁的青壮年高血压病例238例,同时选择年龄、性别、职业及其他条件相匹配的血压正常的青壮年人250名作对照。询问病史、家族史、职业、生活方式;测量血压、体重、腰围,计算体重指数(BMI)。检查心电图、动态血压监测;心脏超声测量左室质量,并计算左室质量指数(LVMI);检测空腹血糖、血脂、血肌酐(Cr)和血尿酸(UA)。结果青壮年高血压发病率男性高于女性。总的特点是以舒张期高血压为主,24h血压仍以杓型昼夜节律为主;高血压组BMI明显高于正常组(P<0.05)。高血压组49.6%有家族史、55.5%有吸烟史、52.9%血脂异常,与血压正常组比较差异有统计学意义(P<0.01、P<0.05、P<0.01)。高血压组空腹血糖、TG、LDL均高于正常血压组(P<0.01、P<0.01、P<0.05),差异有统计学意义,血脂异常以TG和LDL-C为主,血尿酸、肌酐、胆固醇、高密度脂蛋白两组间差异无统计学意义。体重和腰围高血压组男女两性均高于正常对照组(P<0.05)。高血压组LVMI明显高于正常血压组(P<0.01)。结论青壮年高血压患者男性多于女性,以舒张期高血压为主,家族史、肥胖、代谢紊乱、不良的生活方式是引发青壮年高血压的主要因素。

Clinical study of young adults hypertension

Objective To study clinical characteristics of hypertension of young adults.Methods Based on the criteria of the National Guideline for prevention and treatment of hypertension established by Chinese Hypertension Alliance in 1999,we elect 238 patients aged from 25 to 44.At the same time we set a contrast group of 250 young adults whose blood pressure are normal.We inquire their medical history,family history,career,life style,and measure their blood pressure,weight,and waistline and estimate the BMI,check electrocardiogram and ambulatory state blood pressure monitoring,use sicker voice of heart to measure the left ventricular mase and estimate LVMI.We also detect the fasting blood glucose,Lipids,Cr and UA.Results The male's hypertension of young adults is much higher than female's,which is characterized mainly by diastolic hypertension and majorly dippers.BMI of the hypertension group is obviously higher than that of contrast group(P<0.05).Among the hypertension group 49.6 have family medical history,55.6 have smoking history,and 52.9 have higher lipids,which are clearly different form the contrast group(P<0.01,P<0.05,P<0.01).The fasting blood glucose,TG and LDL of hypertension group are all higher than those of normal blood pressure group(P<0.01,P<0.01,P<0.05).Dyslipidemia majorly obtains higher TG and LDL-C level.The weight and waistline of male and female in hypertension group are higher than those in contrast group.LVMI in hypertension group is also obviously higher than that in contras group.Conclusion The male's hypertension of young adults is much higher than female's,which is characterized mainly by diastolic hypertension.Family history,obesity,metabolism and bad life style are main causes of hypertension.