隐性高血压的影响因素研究

Influencing Factors for Masked Hypertension

目的探讨隐性高血压(MH)的影响因素。方法在2010年1月—2015年4月到南方医科大学附属北京军区总医院心血管内科就诊的10 040例患者中,连续选取高血压患者250例(高血压组),MH患者250例(MH组),正常血压患者250例(对照组)。收集3组患者的一般资料和实验室检测指标,采用多元Logistic回归分析探讨MH的影响因素。结果 3组患者性别、BMI及高血压家族史比例比较,差异有统计学意义(P<0.05);而平均年龄及有吸烟史、饮酒史比例比较,差异无统计学意义(P>0.05)。3组患者血清空腹血糖(FPG)、高密度脂蛋白(HDL)、尿素氮(BUN)及钾离子水平比较,差异无统计学意义(P>0.05);而血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、尿酸(UA)、肌酐(Cr)及丙氨酸氨基转移酶(ALT)水平比较,差异有统计学意义(P<0.05)。不同高血压家族史MH患者的平均年龄比较,差异无统计学意义(P>0.05)。多元Logistic回归分析显示,BMI、高血压家族史对MH的影响有统计学意义(P<0.05)。结论 BMI和高血压家族史是患MH的影响因素,临床上应注意对BMI较高和有高血压家族史人群进行筛查。

Objective To investigate the influencing factors for masked hypertension. Methods Among 10 040 patients who received treatment in the Department of Cardiology of General Hospital of Beijing Military Area Command Affiliated to Southern Medical University from January 2010 to April 2015,we consecutively selected 250 hypertensive patients（ hypertension group）,250 MH patients（ MH group） and 250 normal hypertensive patients（ control group）. General data and laboratory indexes were collected,and the influencing factors for MH were investigated by multivariate logistic regression analysis. Results The three groups were significantly different in gender,BMI and the proportion of patients with family history of hypertension（ P 〈0. 05）,but were not significantly different in average age,the proportion of patients with smoking history and the proportion of patients with history of alcohol consumption（ P〉 0. 05）. The three groups were not significantly different in FPG,HDL,BUN and potassium ion level（ P〉 0. 05）,but were significantly different in the levels of TC,TG,LDL,UA,Cr and ALT（ P〈 0. 05）. MH patients with different family history of hypertension were not significantly different in average age（ P 〉0. 05）.Multivariate logistic regression analysis showed that BMI and the family history of hypertension had significant influence on MH. Conclusion BMI and the family history of hypertension are influencing factors for MH. Therefore,the screening of patients with high BMI and the family history of hypertension should be emphasized.