单纯舒张期高血压的患病率及临床特征

Prevalence and clinical characteristics of isolated diastolic hypertension in untreated hypertensive outpatients

目的:探讨未接受降压治疗的高血压门诊患者的单纯舒张期高血压(isolated diastolic hypertension,IDH)患病率及其临床特征。方法:共调查了30～81岁未接受降压治疗的高血压门诊患者864例,根据24 h动态血压水平(24 h平均收缩压<130 mm Hg且平均舒张压≥80 mm Hg)定义IDH。采用方差分析及卡方检验比较IDH与正常血压者及其他类型高血压患者间临床特征的差异。结果:864例患者中,高血压患病率为62.7%,其中IDH患病率为26.2%。455例青中年(<60岁)高血压患者中,IDH占43.7%,而单纯收缩期高血压仅占4.2%,收缩、舒张双期高血压占52.1%。IDH患者的体质量、体质量指数、腰围、内脏脂肪指数、24 h心率、血尿酸水平均较正常血压者明显升高(P<0.05)。此外,IDH组中男性、饮酒比例较高(P<0.05)。结论:IDH主要见于中青年男性,超重、腹型肥胖、高尿酸血症及饮酒等是其重要影响因素。

Objective To investigate the prevalence and clinical characteristics of isolated diastolic hypertension （IDH） in untreated hypertensive outpatients. Methods A total of 846 adults aged 30 to 81 years were investigated in this study. IDH was defined as a 24-hour mean blood pressure 〈130 mm Hg systolic and I〉80 mmHg diastolic. Analysis of variance and chi-square test were used to analyze the differences in clinical characteristics between patients with IDH, those with other types of hypertension and normotensives. Results In this patient cohort, the prevalence of hypertension and IDH was 62.7% and 26.2%, respectively. Among young and middle-aged hypertensive patients （n=455）, 43.7%, 4.2% and 52.1% patients had IDH, ISH （isolated systolic hypertension）, and SDH（systolic and diastolic hypertension）, respectively. Compared with normotensive subjects, IDH patients had higher （P〈0.05） body weight, body mass index, waist circumference, visceral fat index, 24-hour heart rate, and serum uric acid. Furthermore, IDH patient group had more male, and more frequently （P〈0.05） reported drinking. Conclusions IDH is mainly diagnosed among young and middle-aged men. Overweight, central obesity, hyperuricemia, and alcohol consumption are important risk factors of IDH.