隐蔽性高血压患者中心动脉压及增强指数与动脉弹性的相关性

Relationship between central blood pressure and its reflected wave with arterial elasticity in masked hypertensive patients

目的探讨隐蔽性高血压患者中心动脉压及增强指数与动脉弹性的关系。方法选择临床诊断血压正常者360例及高血压患者100例监测24h动态血压,根据监测结果将受试者分为隐蔽性高血压组(n=135)、血压正常组(n=225)及高血压组(n=100)。应用大动脉测量仪测量中心动脉压及其反射波;应用脉搏波传导速度测定仪测定颈桡动脉脉搏波传导速度(crPWV)。结果隐蔽性高血压组中心动脉收缩压(CSP)、舒张压(CDP)、中心脉压(CPP)、平均收缩压(CMSP)、平均舒张压(CMDP)、收缩末压(CESP)、增强压(AUG)、crPWV均高于血压正常组,低于高血压组(P<0.01或P<0.05)。校正性别和年龄后,多元线性回归分析显示CSP、CPP、总胆固醇是crPWV的影响因素(B值分别为0.043,0.085,0.792;均P<0.01)。结论隐蔽性高血压患者动脉粥样硬化和中心动脉压相关,CSP和CPP是影响动脉硬化程度的独立危险因素。

Objective To investigate if central blood pressure and its reflected wave augmentation index are associated with arterial elasticity in masked hypertensives. Methods Three hundred sixty adults normotensives （office blood pressure〈140/90 mm Hg） and 100 hypertensives （office blood pressure≥140/90 mm Hg or receiving antihypertension medications） underwent 24 h ambulatory blood pressure monitoring. Based on the blood pressure, all the patients were categorized into masked hypertensives （n=135）, normotensives （n= 225） and hypertensives （n= 100 ） respectively. Central blood pressure and its reflected wave were measured noninvasively with SphygmoCor device, and carotid-radial pulse wave velocity （crPWV） was detected by Complior. Results Central systolic pressure （CSP） , central diastolic pressure （CDP）, central PUlSe pressure （CPP）, central mean systolic （CMSP）, central mean diastolic （CMDP）, central end systolic pressure （CESP）, P1 Height, augmentation pressure （AUG） and the values of crPWV were higher in masked hypertensives than those in normotensives （P〈0.01 or P〈0.05}, but lower than those in hypertensives （P〈0.01 or P〈0.05}. After adjusted for sex and age, multiple linear regression analysis showed CSP, CPP, total cholesterols are independent risk factors affecting crPWV （B values were 0. 043, 0. 085, 0. 792; all P〈0. 05）. Conclusion Atherosclerosis in patients with masked hypertension is associated with central aortic pressure; CSP and CPP are the important influencing factors of arterial stiffness.