长期饮酒对男性高血压患者血压晨峰的影响及与左室肥厚的相关性

Effect of long-term alcohol consumption on morning blood pressure surge and its association with left ventricular hypertrophy in male hypertension patients

目的探讨长期饮酒对男性高血压患者血压晨峰(MBPS)的影响及与左室肥厚(LVH)的相关性。方法随机选择男性高血压患者199例,根据问卷调查结果将入选患者分为不饮酒组、戒酒组和轻度、中度、重度饮酒组。检测患者的空腹血糖(FPG)及血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL),测量心率(HR)、体质量指数(BMI),行24h动态血压监测和超声心动图检查,并计算左室质量指数(LVMI)。对不同组检测的参数进行统计学分析。结果各组患者FPG、TC、TG、HDL、LDL HR、BMI等参数比较差异均无统计学意义(P>0.05)。不饮酒组、戒酒组、轻度饮酒组患者24h平均收缩压(24hSBP)、白昼平均收缩压(dSBP)、夜间平均收缩压(nSBP)较中、重度饮酒组低(P<0.05),杓型收缩压百分率、杓型舒张压百分率较中、重度饮酒组高(P<0.05),MBPS值和MBPS增高发生率较中、重度饮酒组低(P<0.05),LVMI和LVH发生率较中、重度饮酒组低(P<0.05)。不饮酒组、戒酒组、轻度饮酒组各项参数比较差异无统计学意义(P>0.05)。中、重度饮酒组患者平均每日酒精摄入量与MBPS值、LVMI呈正相关(P<0.05)。结论长期中、重度饮酒可以影响男性高血压患者的血压昼夜节律,加重MBPS现象与LVH;随着饮酒量的增加,MBPS现象与LVH的程度也会相应增加。

Objective To explore the effect of long-term alcohol consumption on morning blood pressure surge（MBPS）and its association with left ventricular hypertrophy（LVH）in males with hypertension.Methods According to the findings of our questionnaire survey,199 male patients with hypertension were divided into non-drinking,giving up drinking and mild,moderate and heavy drinking groups.The fasting plasma glucose（FPG）,serum total cholesterol（TC）,triglycerides（TG）,high density lipoprotein（HDL）,low density lipoprotein（LDL）,heart rate（HR）and body mass index（BMI）were examined in all patients.The 24-hour ambulatory blood pressure monitoring and echocardiography were performed and the left ventricular mass index（LVMI）were calculated.The data were analyzed by using SPSS 10.0software.Results The FPG,TC,TG,HDL,LDL HR,BMI and other parameters had no significant differences among the 5groups（P〉0.05）.The levels of 24-hour mean systolic blood pressure（24hSBP）,daytime mean systolic blood pressure（dSBP）and nighttime mean systolic blood pressure（nSBP）in the non-drinking,giving up drinking and mild drinking groups were significantly lower than those in the moderate and heavy drinking groups（P〈0.05）.The percentages of dipper systolic blood pressure and dipper diastolic blood pressure were significantly higher,the MBPS value,incidence of increased MBPS,LVMI and incidence of LVH were significantly lower than those in the moderate and heavy drinking groups（P〈0.05）.The above parameters were not significantly different among non-drinking,giving up drinking and mild drinking groups（P〉0.05）.The average daily alcohol comsumption was positively correlated with MBPS value and LVMI in the moderate and heavy drinking groups（P〈0.05）.Conclusion Long-term moderate and heavy drinking can affect the circadian rhythm of blood pressure,and aggravate MBPS and LVH in males with hypertension.The MBPS and degree of LVH increase with the increase in alcohol consumption.