原发性高血压患者24小时收缩压平均真实变异性与室间隔厚度相关

    Twenty-four-hour average real systolic blood pressure variability is associated with septal thickness in patients with essential hypertension

      摘要
    • 摘要:
      目的 探讨原发性高血压患者24 h血压变异性（blood pressure variability，BPV）与室间隔厚度的关系。
      方法 收集2020年1月～2020年12月在西安交通大学第一附属医院心内科住院并确诊为原发性高血压的患者347例为研究对象，其中男性216例（62.2%），女性131例（37.8%），年龄（50 ± 15）岁，进行24 h动态血压监测获取患者24 h血压变异性，超声心动图检测室间隔厚度（interventricular septal thickness，IVST），并分为室间隔正常组（normal interventricular septal thickness higher，NIVSH，289例）和室间隔增厚组（interventricular septal thickness higher，IVSH，58例），分析两组患者24小时BPV与IVST的关系。
      结果  IVSH组血压变异标准差（standard deviation，SD）及平均真实变异性（average true variability，ARV）均高于NIVSH组（均P<0.05）。相关性分析结果显示，总人群中SD及ARV与IVST呈显著正相关（均P<0.05）。多元线性回归分析结果显示，24 h收缩压ARV与IVST相关性最强β=0.099(0.050～0.148)，P<0.01。亚组分析结果显示，女性、老年人（>65岁）、超重、糖尿病患者，24 h收缩压ARV与IVST的相关性更强。
      结论  与NIVSH组相比，IVSH组的血压变异性升高，24 h收缩压ARV与IVST在老年女性、超重及糖尿病患者相关性更强。

       

      Abstract:
      AIM To investigate the relationship between 24-hour blood pressure variability (BPV) and septal thickness in patients with essential hypertension.
      METHODS A total of 347 patients hospitalized in the Department of Cardiology of the First Affiliated Hospital of Xi’an Jiaotong University and diagnosed with essential hypertension from January 2020 to December 2020 were collected as the study subjects, including 216 males (62.25%) and 131 females (37.75%), with an average age of (50.30 ± 15.07) years. Twenty-four-hour ambulatory BP monitoring was performed to obtain the patients’ 24-hour blood pressure variability and interventricular septal thickness (IVST) was detected by echocardiography. The patients were divided into a normal interventricular septum group (NIVSH, 289 cases) and a thickened interventricular septum group (IVSH, 58 cases) according to IVST, and the relationship between 24-hour BPV and IVST was analyzed between the two groups.
      RESULTS The standard deviation of blood pressure variation (SD) and average real variability (ARV) in the IVSH group were higher than those in the NIVSH group (both P<0.05). The results of correlation analysis showed that SD and ARV were significantly positively correlated with IVST in the total population (both P<0.05). The results of multiple linear regression analysis showed that the mean true variability of 24-hour systolic blood pressure had the strongest correlation with IVST β=0.099(0.050～0.148), P<0.01. Subgroup analyses showed that the mean true 24-hour systolic blood pressure variability was more strongly correlated with IVST in women, elderly (>65 years), overweight, and diabetic patients.
      CONCLUSION Blood pressure variability is increased in patients with thickened interventricular septum. Average real variability of 24-hour systolic blood pressure correlates more strongly with IVST in women, elderly, overweight, and diabetic patients.

       

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