血压正常高值者24小时动态血压分析

姚光涛; 路方红; 刘振东; 赵颖馨; 王舒健; 孙尚文; 金世宽

血压正常高值者24小时动态血压分析

Analysis of 24-hour ambulatory blood pressure in prehypertensive subjects

摘要

摘要: 目的: 探讨以偶测血压为诊断标准血压正常高值人群的24 h动态血压特点。方法: 采用动态血压测定仪分别对理想血压组82例、血压正常高值组183例及高血压组127例受试者进行24 h动态血压检测（ABPM）。结果: 24 h收缩压变异系数（24hSSD）理想血压组、血压正常高值组、高血压组分别为（14.0±2.1）%、（17.2±3.2）%和（20.5±4.6）%； 24 h舒张压变异系数（24hDSD）3组分别为（10.4±1.9）%、（13.1±1.9）%和（16.3±2.1）%；非杓型血压所占比例分别为7%、25%、39%；收缩压负荷率（SBP-L）为（12±10）%、（35±20）%和（67±25）%；舒张压负荷率(DBP-L)为（12±9）%、（33±20）%和（62±25）%；血压正常高值组较理想血压组高、较高血压组低（分别P<0.05，P<0.01）；收缩压夜间下降率（SBPF）分别为（17．4±4.3）%、（12.5±3.3）%和（9．2±3.6）%；舒张压夜间下降率为（DBPF）（16．1±3.7）%、（11.4±2.9）%和（9.1±3.3）%，较理想血压组低、较高血压组高（P<0.01）。结论: 正常高值人群较理想血压组血压平均水平升高，血压变异、血压负荷、非杓型血压比例增加，夜间血压下降率降低。

Abstract: AIM: To explore the characteristics of ambulatory blood pressure monitoring (ABPM) in prehypertensive subjects. METHODS: According to resting blood pressure levels, 392 subjects were divided into three groups: normotensive group (n=82), prehypertensive group (n=183) and essential hypertensive group (n=127). A 24-h ABPM was performed in all patients. RESULTS: The 24-h BP variation coefficient of SBP (24-h SSD) in normotensive, prehypertensive and hypertensive subjects were, respectively, (14.0±2.1)%, (17.2±3.2)% and (20.5±4.6)%. The 24-h BP variation coefficient of DBP (24-h DSD) was (10.4±1.9)%, (13.1±1.9)% and (16.3±2.1)%, and the proportion of non-dipper blood pressure was 7%, 25% and 39%. SBP load (SBP-L) was (35±20)% and DBP load was (33±20)% (P<0.05, P<0.01). The rate of decrease of SBP at night (SBPF) was 13% and the rate of decrease of DBP at night (DBPF) was 11%, lower than that of the normotensive group but higher than that of the hypertensive group (P<0.01). CONCLUSION: The circadian pattern of BP significantly changed in the prehypertensive group. BP level, BP variability rate, BP load rate, and the proportion of non-dipper BP all increased, whereas SBPF and DBPF decreased.

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