高校社区H型高血压的发病特点及叶酸在H型高血压中的治疗作用

Clinical characteristics of H type hypertension in a university community and the effect of folic acid on the treatment of H type hypertension

目的分析高校社区H型高血压的发病特点及应用小剂量叶酸治疗H型高血压的作用。方法2012年11-12月观察社区内2009年12月前确诊的576例原发性高血压患者,通过检测血浆同型半胱氨酸（homocysteine,Hcy）水平将患者分为H型高血压组405例（Hcy≥10μmol/L）,与非H型高血压组（Hcy〈10μmol/L）171例。比较两组患者的血压、血糖、血脂、Hcy水平及2009-2012年脑卒中、冠心病的发病率;同时将405例H型高血压患者中自愿服药的293例患者设为治疗组,其余112例患者设为对照组。对照组常规口服降压药物治疗,治疗组除口服降压药外给予0.8 mg叶酸每日一次口服,于2013年11-12月观察叶酸的治疗效果。结果社区中原发性高血压患者中H型高血压的患病率为70.3%,非H型高血压与H型高血压患者相比,收缩压、胆固醇、Hcy水平及心脑血管事件的发病率等指标差异有统计学意义（P〈0.05）。治疗组在口服叶酸一年后与服药前相比Hcy、收缩压、胆固醇等水平有显著下降,差异有统计学意义（P〈0.05）。结论口服小剂量叶酸可以有效降低Hcy水平,对于控制H型高血压、降低心脑血管事件的风险有一定的意义。

Objective To analyze the clinical characteristics of H type hypertension in a university community and the effect of small dose of folic acid in the treatment of H type hypertension. Methods Five hundred and seventy-six essential hypertension patients who were diagnosed before Dec 2009 in a University community were analyzed,in which,405 patients were diagnosed as H type hypertension based on detecting the high level of plasma homocysteine（ Hcy）,and the other 171 patients were diagnosed as Non-H type hypertension. The two groups were analyzed retrospectively with the sex,age,blood pressure,fasting blood sugar,blood lipid and the incidence of the vascular events（ 2009 - 2012）,including coronary heart disease and stroke. Then,those 405 H type hypertension patients were divided into two groups with the principle of voluntary： treatment group（ 293 patients） and control group（ 112 patients）. The both groups were treated with conventional hypertension medications. In addition,the treatment group was administered orally 0. 8 mg folic acid once a day. The therapeutic effects were compared between the two groups of patients after one year. Results The prevalence of H type hypertension in our community was 70. 3%. Compared with the Non-H type hypertension,the levels of blood pressure,cholesterol,HCY,and the incidence of cardiovascular events were significantly higher（ P〈0. 05）. After one year treatment of folic acid（ 0. 8mg per day）,the levels of Hcy,blood pressure,cholesterol of patients in the treatment group decreased significantly compared with the control group（ P〈0. 05）. Conclusion Oral lowdose folic acid can reduce the HCY level in H type hypertention,also reduce the risk of cardiovascular events.