高血压病亚临床靶器官损害的评估对心血管危险分层的影响

Effects of subclinical target organ damage evaluation on total cardiovascular risk stratification in patients with hypertension

目的:探讨除了血压水平危险分层外,不同亚临床靶器官损害的检测评估对高血压病患者心血管危险分层的影响。方法:258例住院高血压病患者,除了常规检测项目外,还进行心脏彩超及颈动脉内中膜层厚度的测量,依据2005年中国高血压防治指南,对血压水平及添加亚临床靶器官损害评估后的高血压病患者进行危险分层。结果:高血压病患者根据血压水平危险分层。低危60例(23.2%);中危115例(44.6%);高危83例(32.2%)。这些低中危的患者通过亚临床靶器官损害评估后再行危险分层,其高危组患者所占比率明显升高,为219例(84.9%),相比较血压水平危险分层具有明显的统计学差异(P<0.01)。结论:亚临床靶器官损害的检测评估可提高高血压病高危患者的检出率。

AIM： To assess the effect of evaluation of different forms of subclinical organ damage （SOD）, in addition to the level of blood pressure, on total cardiovascular risk stratification in patients with hypertension. METHODS： Totally, 258 hypertensive patients underwent laboratory examinations, and their left ventricular and cartid artery structure were measured. The patients were divided into risk categories according to Hypertension Prevention Guide 2005 China before and after SOD evaluation. RESULTS： By the level of blood pressure, the patients were classified as： 23.2% with low cardiovascular risk, 44. 6% with moderate cardiovascular risk, and 32. 2% with high cardiovascular risk. The proportion of patients with low or moderate cardiovascular risk were reclassified by SOD evaluation： the proportion of patients with high risk was 84. 9% （ χ2 p 〈 0. 01 ）. CONCLUSION： Evaluation of different forms of SOD may significantly change the total cardiovascular risk stratification in patients with hypertension.