社区中、老年人群高血压前期对颈动脉粥样硬化斑块形成的影响

The impact of prehypertension on carotid atherosclerotic plaque formation in a middle-aged and elderly community population

目的探讨社区中、老年人群高血压前期与颈动脉粥样硬化斑块形成的关系。方法分别对942名46～75岁广州社区居民进行问卷调查、体格检查、血生化检验和双侧颈动脉超声检查,根据JNC-7的血压分类标准,比较正常血压(normotension,NT)、高血压前期(prehypertension,Pre-HT)和高血压(hypertension,HT)3亚组人群颈动脉粥样硬化斑块形成的差异。结果Pre-HT和HT均与高龄、男性、肥胖、血脂异常、吸烟的危险因素相关。控制相关危险因素后,Pre-HT颈动脉粥样硬化斑块形成是NT的2.37倍(95%CI:1.42～3.95,P<0.01),Pre-HT与HT之间颈动脉粥样硬化斑块形成的差异不明显(P>0.05)。与HT相比,Pre-HT颈动脉粥样硬化斑块以低回声斑块较多。结论高血压前期与颈动脉粥样硬化斑块形成风险增高相关,处于高血压前期的中、老年人群已存在较明显的靶器官损害——颈动脉粥样硬化斑块形成。

Objective To study the impact of prehypertension on carotid atherosclerotic plaque formation in a mid- die-aged and elderly population. Methods We studied nine hundred and forty-two residents in a community of Guang- zhou, China by questionnaires, physical examinations, blood chemistry tests and bilateral carotid ultrasonography. Differences of plaque formation were compared among the three populations of normotension （NT）, prehypertension （Pre-HT） and hypertension （ HT）, which were stratified by the JNC-7 classification of blood pressure. Results Pre-HT and HT were associated with the risk factors such as older age, male gender, dyslipidemia, obesity and smoking. Adjusting for relevant risk factors, carotid atherosclerotic plaque formation rate in the Pre-HT was as 2.37 times as that of NT （95% CI： 1.42 N 3.95, P 〈 0. 01 ）, difference of plaque formation rate between Pre-HT and HT was not significant （ P 〉 0. 05 ）. Echolucent plaques were more prevalent in Pre-HT population than in HT population. Conclusions Prehypertension is associated with high risk of carotid atherosclerotie plaque formation and carotid atheroselerotic plaque formation are common among patients with the prehypertension in a middle-aged and elderly population.