高血压病患者血压晨峰与心血管重构的关系

李萍; 李俭春; 周国宝; 孙康云

高血压病患者血压晨峰与心血管重构的关系

Association between morning blood pressure surge and cardiovascular remodeling in patients with hypertension

摘要

摘要: 目的: 观察高血压病患者血压晨峰（morning blood pressure surge,MBPS）与心脏肥大和颈动脉内膜-中膜厚度(IMT)的关系。方法：高血压病患者386例。根据动态血压检测结果，分为晨峰组（146例）和非晨峰组（240例），全部病例同步记录24 h动态血压和动态心电图，观察指标为24 h动态血压参数；超声技术检测左室质量指数（LVMI）、左房内径（LAD）、颈动脉IMT等指标。结果：晨峰组与非晨峰组比较：LVMI分别为（119±21）g/m2和（92±12）g/m2(P<0.01) ；LAD分别为（46±11）mm与（38±10）mm（P<0.05）；颈动脉IMT分别为（1.36±0.24）mm与（0.92±0.18）mm（P<0.01）；左室肥厚(LVH)的检出率分别为67%与30%（P<0.01）。结论：与无血压晨峰的高血压病患者比，具有血压晨峰的高血压病患者LVH和颈动脉硬化更显著，心血管重构更显著，左心房内径更大。

Abstract: AIM: To evaluate the association between morning blood pressure surge (MBPS) and cardiovascular remodeling in hypertensive patients. METHODS: A cohort of 386 patients with hypertension under 24 h ambulatory blood pressure monitoring were categorized as MBPS group (n=146) and non-MBPS group (n=240). Left ventricular mass index (LVMI) and thickness (IMT) of carotid artery were measured by ultrasonography in all patients and left ventricular hypertrophy (LVH), left atrial dimension (LAD) and intima-media thickness were compared between groups. RESULTS: Compared with those in the non-MBPS group, LVMI ［(119±21)g/m2 vs.(92±12)g/m2, P<0.01］, LAD ［(46±11)mm vs. (38±10)mm, P<0.05］, IMT of carotid artery ［(1.36±0.24)mm vs. (0.92±0.18)mm, P<0.05］ and LVH (67% vs. 30%, P<0.01) were significantly higher in the MBPS group. CONCLUSION: Hypertensive patients with MBPS have more severe LVH and carotid atherosclerosis and larger LAD compared with those of hypertensive patients without MBPS. MBPS is associated with more significant cardiovascular remodeling.

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