正常高值血压者血压晨峰水平与冠状动脉病变程度的关系

Correlation analysis between blood pressure morning peak of high-normal blood pressure and severity of coronary artery disease

目的探讨正常高值血压者血压晨峰水平与冠状动脉病变严重程度的相关性。方法对我院收治的180例正常高值血压患者进行24 h动态血压监测(ABPM)以及冠状动脉造影(CAG)。按ABPM有无晨峰现象分为晨峰组(67例)与非晨峰组(113例),比较两组患者的ABPM、冠状动脉病变支数,分析冠状动脉病变的影响因素。结果晨峰组白昼、夜间、24 h、晨峰平均收缩压(MSBP)均明显高于非晨峰组(t依次为2.59、3.46、2.71、11.89,均P<0.05);晨峰组患者的冠状动脉病变支数明显多于非晨峰组(U=4.587 0,P<0.01);晨峰组Gensini总积分明显高于非晨峰组(t=41.82,P<0.01);多元线性回归分析显示,血压晨峰(MBPS)、24 h平均舒张压(MDBP)、空腹血糖、年龄为冠状动脉病变的独立危险因素。结论正常高值血压者血压晨峰与冠状动脉病变严重程度密切相关,是预测冠心病发生及严重性的独立危险因素,有效控制正常高值血压患者的晨峰血压可减少对靶器官的损害。

Objective To investigate the correlation between blood pressure morning peak of high-normal blood pressure and severity of coronary artery disease. Methods 180 eases of patients with high-normal blood pressure in our hospital were given 24 h ambulatory blood pressure monitoring （ambulatory blood pressure monitoring, ABPM） and coronary angiography （coronary angiography, CAG）. They were divided into morning peak group （67 cases） and non-morning peak group （113 cases） according to ABPM whether or not the morning peak phenomenon, ABPM, coronary artery lesions of two groups were compared, factors of coronary artery lesions were analyzed. Reslilts The morning peak group 24 h, day, night, morning peak systolic blood pressure were significantly higher than the average morning peak group （in turn, the value of t was 2.59, 3.46, 2.71, 11.89, all P〈0.05）; Coronary artery lesions of morning peak group of patients were significantly more than non-morning peak group （U=4.587 0, P〈0.01）; Gensini total score of morning peak group was significantly higher than the morning peak group （P〈0.01）; Multiple linear regression analysis showed that, MBPS, 24 h average systolic blood pressure, fasting glucose, age were independent risk factors for coronary artery disease. Conclusion The high-normal blood pressure is closely related to MBPS severity of coronary artery disease, is an independent risk factor for coronary heart disease prediction and severity, effectively control blood pressure in patients with high-normal blood pressure can reduce morning peak target organ damage.