汉族人群中血压与动脉硬化关系的研究

Study of Relationship Between Blood Pressure Measured at Home and Arterial Stiffness in Chinese Han Population

目的 :探讨汉族人群中家庭测量血压与动脉硬化的关系。方法 :将 471名受试者分为青年组 (n =2 3 5 )和中年组 (n =2 3 6) ,各组又分为血压正常者和高血压者。对受试者进行 2次家访 ,每次家访各测 5次血压 ,取其 10次读数的平均值作为血压值。应用动脉脉搏波分析 (PWA )仪记录受试者桡动脉脉搏波形 ,经计算机自动转化为中心动脉脉搏波 ,以反射波增强指数 (AIx)作为反映全身动脉硬化的参数。结果 :血压正常者PWA结果显示 ,中年组与青年组比较增强指数有极显著性差异 (P <0 .0 1) ,经年龄调整后两组间无显著性差异。两组中高血压者与血压正常者比较增强指数均升高 ,有极显著性差异 (P均 <0 .0 1)。即使在血压正常者中 ,血压正常高值者 (血压 13 0～ 13 9/ 85～ 89mmHg ,1mmHg =0 .13 3kPa)增强指数也显著高于血压正常值者 (血压 <13 0 / 85mmHg ,P <0 0 0 1)。将增强指数作为因变量 ,年龄、身高、心率、家访时的收缩压及舒张压作为自变量进行多元回归分析显示 ,受试者年龄及收缩压与增强指数呈显著的正相关。结论 :血压正常者中 ,增强指数随年龄的增加而升高。高血压者与血压正常者相比 ,增强指数显著升高 ,提示高血压患者动脉顺应性下降、动脉硬化 ;收缩压与动脉顺应性显著相关。即使血压正常高值者 ,增?

Objective: To explore the relationship between blood pressure measured at home and arterial stiffness in Chinese Han population. Methods:Via random population sampling and enrollment at specialized hypertension clinic, 125 nuclear families and 510 subjects were recruited from January, 2001 to December, 2001. Radial artery pressure waveforms were obtained in 471 subjects noninvasively by applanation tonometry and corresponding central waveforms were generated by using a general transfer function. Augmentation index (AIx) was determined. Results: Central artery AIx was increased in the middle-aged individuals with normal blood pressure than in the young individuals, but the difference was no significant after adjustment for age. AIx was also significantly higher in patients with hypertension than in normotensives (p<0.01). Even in subjects with high-normal blood pressure (BP:130-139/85- 89 mmHg), AIx was significantly higher than those with normal blood pressure (BP<130/85 mmHg,p<0.001). In a multiple regression model, age and systolic blood pressure measured at home were positively correlated with AIx. Conclusion: AIx increases with aging in normotensives. Patients with hypertension have a higher AIx and stiffer blood vessels compared with normotensives. Age and systolic blood pressure positively is correlated with arterial stiffness. AIx was significantly higher even in subjects with high-normal blood pressure than those with normal blood pressure, which suggests that arterial function has changed before hypertension occurs.