血压正常高值者24小时动态血压分析

Analysis of 24-hour ambulatory blood pressure in prehypertensive subjects

目的:探讨以偶测血压为诊断标准血压正常高值人群的24 h动态血压特点。方法:采用动态血压测定仪分别对理想血压组82例、血压正常高值组183例及高血压组127例受试者进行24 h动态血压检测(ABPM)。结果:24 h收缩压变异系数(24hSSD)理想血压组、血压正常高值组、高血压组分别为(14.0±2.1)%、(17.2±3.2)%和(20.5±4.6)%;24 h舒张压变异系数(24hDSD)3组分别为(10.4±1.9)%、(13.1±1.9)%和(16.3±2.1)%;非杓型血压所占比例分别为7%、25%、39%;收缩压负荷率(SBP-L)为(12±10)%、(35±20)%和(67±25)%;舒张压负荷率(DBP-L)为(12±9)%、(33±20)%和(62±25)%;血压正常高值组较理想血压组高、较高血压组低(分别P<0.05,P<0.01);收缩压夜间下降率(SBPF)分别为(17.4±4.3)%、(12.5±3.3)%和(9.2±3.6)%;舒张压夜间下降率为(DBPF)(16.1±3.7)%、(11.4±2.9)%和(9.1±3.3)%,较理想血压组低、较高血压组高(P<0.01)。结论:正常高值人群较理想血压组血压平均水平升高,血压变异、血压负荷、非杓型血压比例增加,夜间血压下降率降低。

AIM： To explore the characteristics of ambulatory blood pressure monitoring （ABPM） in prehypertensive subjects. METHODS： According to resting blood pressure levels, 392 subjects were divided into three groups ： normotensive group （ n = 82）, prehypertensive group （ n = 183 ） and essential hypertensive group （n = 127）. A 24-h ABPM was performed in all patients. RESULTS： The 24-h BP variation coefficient of SBP （24-h SSD ） in normotensive, prehypertensive and hypertensive subjects were, respectively, （ 14.0 ± 2. 1 ） %, （ 17.2 ±3.2 ） % and （20. 5 ±4. 6 ） %. The 24-h BP variation coefficient of DBP （24-h DSD） was （10.4±1.9）%, （13.1 ±1.9）% and （16.3±2. 1）%, and the proportion of non-dipper blood pressure was 7%, 25% and 39%. SBP load （SBP-L） was （35± 20）% and DBP load was （33± 20）% （P 〈 0. 05, P 〈 0. 01 ）. The rate of decrease of SBP at night （SBPF） was 13% and the rate of decrease of DBP at night （DBPF） was 11%, lower than that of the normotensive group but higher than that of the hypertensive group （ P 〈 0. 01 ）. CONCLUSION ： The circadian pattern of BP significantly changed in the prehypertensive group. BP level, BP variability rate, BP load rate, and the proportion of non-dipper BP all increased, whereas SBPF and DBPF decreased.