超重/肥胖与动态血压变化的关系

The relationship between variation of overweight or obesity and ambulatory blood pressure

目的:探讨超重/肥胖和动态血压(ABP)变化的相互关系。方法:根据体重指数(BMI)共选择121例肥胖(n=62)、超重(n=39)和正常对照组(n=20)做24h动态血压检测(ABPM),比较3组ABP值的变化。结果:24h、日间和夜间平均收缩压和舒张压水平、日间和夜间血压负荷值在肥胖组>超重组>正常对照组(P<0.01),以夜间收缩压升高更明显;30%超重和56.8%肥胖者血压昼夜节律消失(P<0.01),夜间血压下降率<10%,呈非杓型曲线;BMI、腰围(WC)和ABP各值、负荷值、夜间血压下降率均呈正相关(r=0.32～0.467,P<0.05～<0.01),相关程度夜间高于日间,WC优于BMI。结论:超重、肥胖或腹型肥胖不仅加重血压负荷,还影响昼夜血压节律,这种改变WC高于BMI,且多出现在夜间。

Objective： To investigate the relationship between overweight or obesity and ambulatory blood pressure （ABP） variation. Method ： A hundred twenty-one patients were divided into three groups ： normal （ n = 20） , overweight（ n = 39）and obesity（ n = 62） according to body mass index （BMI）. The variation of 24 hour ambulatory blood pressure monitoring （ABPM） in three groups were compared. Result： The mean values of ABP and blood pressure load increased prarllal with in the increaese of BMI（ P 〈 0.01 ）. The variation of systolic blood pressure at night increased more significantly ; In the overweight and obesity groups of non-dipper pattern was 30% and 56.8 % （P 〈 0.01 ）. The nighttime blood pressure decrease rate were less than 〈 10% ;The value of ABP. blood pressure lead and nighttime blood pressure decrease rate ware positively correlated to BMI and waist circumference （WC） （P 〈0.05 - 〈0.01）. ConcIusion： The overweight or obesity or abdominal adiposity increased the blood pressure load and circadian blood pressure change, the variation are significantly higher by using WC than by BMI and at night.