饮酒对男性高血压患者血压昼夜节律的影响

The Effect of Long-term Alcohol Intake on Circadian Rhythm of Ambulatory Blood Pressure in Males with Hypertension

目的探讨长期饮酒对男性高血压患者血压昼夜节律的影响。方法选择男性高血压患者167例,根据饮酒调查将入选患者分为不饮酒组51例、戒酒组36例和饮酒组80例。测量入选患者血压、心率、体质量指数(BMI)、空腹血糖,血清总胆固醇、三酰甘油、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和24h动态血压。对测量的参数进行统计学分析。结果各组间在血压、心率、BMI、空腹血糖、血清总胆固醇、三酰甘油、HDL-C、LDL-C等参数比较,差异无统计学意义(P>0.05)。不饮酒组夜间收缩压比饮酒组低[(127.2±15.0)比(136.8±21.6)mmHg,P<0.01],夜间收缩压及舒张压下降幅度较饮酒组高[(9.7±5.1)%及(9.4±5.9)%比(4.4±7.1)%及(3.8±8.3)%,P<0.01]。戒酒组夜间收缩压比饮酒组低[(128.9±17.3)比(136.8±21.6)mmHg,P<0.05],夜间收缩压及舒张压下降幅度较饮酒组高[(8.2±7.1)%及(9.7±6.5)%比(4.4±7.1)%及(3.8±8.3)%,P<0.01]。不饮酒组与戒酒组各项参数比较无差异(P>0.05)。非杓型收缩压在不饮酒组和戒酒组中分别是47.1%(24/51)和61.1%(22/36),显著低于饮酒组的82.5%(66/80)(P<0.01);非杓型舒张压在不饮酒组和戒酒组中分别是56.9%(29/51)和52.8%(19/36),显著低于饮酒组的76.3%(61/80)(P<0.05)。而不饮酒组和戒酒组组间非杓型血压所占比例比较无显著差异(P>0.05)。Logistic逐步回归分析显示非杓型收缩压和非杓型舒张压均与饮酒相关(OR值分别为4.430和2.730,P<0.01)。结论长期饮酒的男性高血压患者夜间血压水平较高,非杓型血压增多,戒酒者夜间血压有所下降,昼夜节律有所恢复。

Objective To investigate the effect of long-term alcohol intake on circadian rhythm of ambulatory blood in male patients with hypertension.Methods According to alcohol intaking surveys,167 male patients with hypertension were divided into non-drinking（n=51）,the give-up drinking（n=36） and drinking group （n=80）.The blood pressure,heart rate,body mass index （BMI）,fasting blood glucose,serum total cholesterol,triglycerides,high density lipoprotein cholesterol （HDL-C）,low density lipoprotein cholesterol （LDL-C） and 24-hour ambulatory blood pressure monitoring were measured.The measured parameters were analyzed by SPSS11.5 soft.Results The blood pressure,heart rate,BMI,fasting blood glucose,serum total cholesterol,triglycerides,HDL-C,LDL-C and other parameters showed no significant differences （P0.05） among 3 groups.The levels of systolic blood pressure at night in non-drinking group were lower than drinking group [（127.2±15.0） vs（136.8±21.6）mm Hg,P0.01],and the decreasing level of systolic blood pressure and diastolic blood pressure at night in non-drinking group were higher compared to drinking group [（9.7±5.1）% and （9.4±5.9）% to（4.4±7.1）% and （3.8±8.3）%,P0.01].The level of systolic blood pressure at night in the give-up drinking group were lower than drinking group （128.9±17.3） to （136.8±21.6） mm Hg,P0.05],and decreasing level of systolic blood pressure and diastolic blood pressure at night on the give-up drinking group were higher compared to drinking group [（8.2±7.1）% and （9.7±6.5）% to （4.4±7.1）% and （3.8±8.3）%,P0.01].Non-drinking group and give-up drinking group showed no difference in all the parameters （P0.05）.Non-dipper systolic blood pressure in non-drinking group and give-up drinking group were 47.1%（24/51）and 61.1%（22/36）,significantly lower than the 82.5%（66/80）in drinking group（P0.01）;Non-dipper diastolic blood pressure in non-drinking group and give-updrinking group were 56.9%（29/51）and 52.8%（19/36）,significantly lower than the 76.3%（61/80）in drinking group（P0.01）.In non-drinking group and give-up drinking group,the proportion of non-dipper blood pressure showed no significant difference（P0.05）.Logistic stepwise regression analysis showed that non-dipper diastolic blood pressure and non-dipper diastolic blood pressure were associated with alcohol usage （OR values were 4.430 and 2.730 respectively （P0.01）.Conclusion With Long-term alcohol intaking,male hypertensive patients have higher night-time,non-dipper blood pressure increase.Give-up drinking results in decreased nocturnal blood pressure and circadian rhythm restored.