正常高值血压的危险因素及其与动脉硬化的相关性分析

The risk factors of prehypertension and the relationship between blood pressure and atherosclerosis

目的探讨正常高值血压的危险因素及血压与动脉硬化的相关性。方法对2011年6月至2012年6月在本院综合医疗科入院体检人群456例进行横断面分析，其中理想血压组174例、正常高值血压组282例，包括人口学特征、血压、血液生化代谢指标、臂踝脉搏波传导速度（baP—wV）、踝臂指数（ABI）及颈动脉内膜中层厚度（CIMT）等。结果与理想血压组相比，正常高值血压组收缩压、舒张压、脉压、体质量指数、空腹血糖、糖化血红蛋白、甘油三酯、尿酸、C反应蛋白水平明显升高（P〈0．05），而高密度脂蛋白明显降低（P〈0．05）；体质量指数（OR=1．185）、甘油三酯（OR=1．302）、空腹血糖（OR=1．690）为正常高值血压的独立危险因素；baPWV、CIMT值明显增高（P〈0．05），而ABI指数和颈动脉粥样斑块发生率无明显变化（P〉0．05）。以baPWV、CIMT为因变量行多元回归分析示：收缩压（β=0．226，p=0．007）、空腹血糖（β=0．209，p=0．018）、年龄（β=0．279，P=0．002）是baPWV的影响因素；收缩压（β=0．118，P=0．015）、体质量指数（β=0．109，P=0．001）、年龄（β=0．396，P=0．001）是CIMT的影响因素。结论体质量指数、甘油三酯、空腹血糖为正常高值血压的独立危险因素。正常高值血压人群已存在动脉硬化的早期亚临床损害，收缩压水平与baPWV、CIMT均密切相关。

Objective To explore the risk factors of prehypertension and the relationship between blood pressure and atherosclerosis. Methods The data of 456 cases in the Department of General Medicine were cross-sectional analyzed, including 174 subjects with normotension and 282 with prehypertension. The information was consisted of demographic characteristics, blood pressure, blood biochemical metabolism in- dex, braehia-ankle pulse wave velocity （baPWV）, ankle-braehial index （ABI） and carotid intima media thickness （CIMT）. Results Compared to normotension group, the levels of systolic pressure, diastolic pressure, pulse pressure, body mass index, fasting blood glucose, glycosylated hemoglobin, triglyceride, u- ric acid, and C-reactive protein in prehypertension group were significantly increased （ P 〈 0.05 ） ; and high-density lipoprotein cholesterol was significantly decreased （ P 〈0. 05 ） ; the body mass index（ OR = 1. 185） , triglyceride（ OR = 1. 302） , and fasting blood sugar （ OR = 1. 690） were the independent risk factors of prehypertension; baPWV and CIMT in prehypertension group were higher, but ABI and artery ath- eromatous plaque rate were not obvious changed. When baPWV or CIMT were set as the dependent varia- bles, multiple linear regression analysis showed that systolic blood pressure（ β = 0. 226, P = 0. 007 ）, fast- ing blood glucose（ β =0. 209, P =0. 018）, and age（ β =0. 279, P =0. 002） were risk factors of baPWV; systolic blood pressure （ β = 0. 118, P = 0. 015 ） , body mass index （ β= 0. 109, P = 0. 001 ）, and age （ β = 0. 396. P = 0. 001 ） were risk factors of CIMT. Conclusions Bodv mass index, triulvcerides_ and fastinblood sugar were the independent risk factors of prehypertension. The early subclinical damage of hardening of the arteries was occurred in the prehypertension cases, and systolic blood pressure was closely related with baPWV or CIMT.