高血压患者血压变异性与脉搏波传导速度的关系

Relationship between blood pressure variability and pulse wave velocity in patients with hypertension

目的比较不同的血压变异性与血管硬化程度的关系,探讨高血压患者日常监测血压更优的方式。方法通过选择2011年9月—2014年3月对成都市武侯区晋阳社区140例高血压患者进行人口学资料收集、行生物化学、肱-踝脉搏波传导速度(brachial-ankle pulse wave velocity,ba PWV)等检查,指导患者规范行家庭血压自我监测及诊室血压测量。收集相关数据,进行统计学分析,比较几种血压变异性和脉搏波传导速度的关系。结果晨起短时家庭血压变异性与ba PWV呈正相关(r=0.313,P=0.011),睡前短时家庭血压变异性与ba PWV呈正相关(r=0.241,P=0.042),天与天间血压变异性与ba PWV呈正相关(r=0.269,P=0.030)。月与月间血压变异性、短时诊室血压变异性与ba PWV的关系无统计学意义(P>0.05)。结论在高血压患者血压变异性的监测中,家庭血压变异性的监测优于诊室血压变异性的监测,且晨起监测优于夜间监测。

Objective To explore the best mode of blood pressure monitoring by comparing the correlation of deferent kinds of blood pressure variability with arterial stiffness. Methods This study was conducted among 140 hypertensive patients in Wuhou Strict, Chengdu. Baseline data was collected including demographic data, biochemical examination and brachial-ankle pulse wave velocity （baPWV） measurement and so on. A consecutive home blood pressure was also gained by the individuals themselves and the clinical blood pressure was also recorded during the visit. The correlation between baPWV and the blood pressure variability were tested. Results The blood pressure variability measured at home in the morning was independently correlated with baPWV （r=0.313, P=0.011）, the blood pressure variability measured at home in the evening was also independently correlated with baPWV （r=0.241, P=0.042）, and day- to-day morning blood pressure variability measured at home was correlated with baPWV （r= 0.269, P=0.030）. The correlation of month-to-month blood pressure variability and blood pressure variability gained at clinic room with baPWV was not significant （P〉0.05）. Conclusion In the monitoring of blood pressure variability in hypertensive patients, the blood pressure variability monitoring at home is better than that at the clinic room; and monitoring in the morning is better than that in the evening.