以血压指数评估原发性高血压患者心脑血管疾病事件的发生情况

Evaluative effects of blood pressure index on the accident of cardiovascular and cerebrovascular diseases in patients with essential hypertension

目的:了解血压指数(脉压/舒张压)对原发性高血压患者心脑血管疾病事件发生情况的评估价值。方法:选择1998-01/2002-01在河南省胸科医院心内科及南阳市中心医院心内科资料完整、诊断明确的住院或门诊原发性高血压患者116例,男82例,女34例,均自愿参加此组观察。血压指数<0.3535例,0.35～0.7034例,>0.7037例。对所有纳入患者进行血压、体质量、身高测量,计算血压指数和体质量指数犤体质量(kg)/身高(m)2犦。于禁食12h后采空腹静脉血,用Beckman全自动系统测定血脂水平。对患者心脑血管疾病事件发生情况进行(3.5±1.5)年随访,随访以电话为主,登门随访为辅。组间比较采用t检验,多组样本率的比较采用χ2检验。结果:①纳入高血压患者116例,随访过程中,失访10人,进入结果分析患者106例。②血压指数随年龄、体质量指数、三酰甘油水平的升高而升高(P<0.05);随高密度脂蛋白胆固醇水平降低而升高(P<0.05)。③血压指数0.35～0.70和>0.70的患者冠心病、心力衰竭、脑血管并发症发生例数明显多于血压指数<0.35者(9,8,10例;13,11,12例;3,2,5例,P<0.05);血压指数>0.70患者冠心病、心力衰竭、脑血管并发症发生例数明显多于血压指数0.35～0.70者(P<0.05)。结论:年龄越大、体质量指数、三酰甘油水平越高,高密度脂蛋白胆固醇水平越低,血压指数越高;心脑血管疾病事件发生情况随血压指数的升高而增加。

AIM： To discuss the evaluative effects of the blood pressure （Bp） index （pulse pressure/diastolic pressure） on the accident of cardiovascular and cerebrovascular disease in patients with essential hypertension. METHODS： 116 patients with essential hypertension, who were treated at the hospitalization or out-patient clinic of Department of Cardiology, Henan Chest Hospital and Department of Cardiology, Nanyang Central Hospital from January 1998 to January 2002, with full data and clear diagnosis were selected, including 82 males and 34 females, and they took part in the observation voluntarily, 35 patients with 〈 0.35 blood pressure index, 34 patients with 0.35-0.70 blood pressure index, and 37 patients with 〉 0.70 blood pressure index. The blood pressure, body mass and height of the included patients were measured, and the blood pressure index and body mass index were calculated [body mass （kg）/height （m）^2. After 12 hours of fasting, the vein blood was gained from the empty abdomen. The level of blood fat was tested by the Beckman full-automatic system. The follow up was performed for （3.5±1.5） years mainly by telephone, and sometimes visits. The comparison among groups was conducted by t-test, and multiple group sample rates were compared by x^2 test. RESULTS： ① 116 patients with hypertension were included, but 10 patients were withdrawn during the process of follow-up, so 106 patients were involved in the result analysis. ② The blood pressure index increased as the increase of age, body mass index and triacylglycerol level （P 〈 0.05）, increased as the decrease of cholesterol of high density lipoprotein （P 〈 0.05 ）. ③ The incidences of coronary heart disease, cardiac insufficiency and cerebrovascular complication in patients with 0.35-0.70 and 〉 0.70 blood pressure index were significantly more than those in patients with 〈 0.35 blood pressure index （9, 8, 10 cases; 13, 11,12 cases; 3, 2, 5 cases, P 〈 0.05）. The incidences of coronary heart disease, cardiac insufficiency and cerebrovascular complication in patients with 〉 0.70 blood pressure index were significantly more than those in patients with 0.35-0.70 blood pressure index （P 〈 0.05）. CONCLUSION： The older the patients is, the higher the body mass index and the triacylglycerol level are, the lower the cholesterol of high density lipoprotein level is, and the higher the blood index is. The occurrence of cardiovascular and eerebrovaseular disease increases with the rise of blood pressure index.