晨峰血压与中年原发性高血压患者脑梗死发病的关系

Relationship between Morning Blood Pressure Surge and Cerebral Infarction in Middle-Aged Essential Hypertensive Patients

目的探讨晨峰血压与中年原发性高血压患者发生脑梗死的相关性。方法选取92例中年原发性高血压患者,其中39例高血压合并脑梗死患者为观察组,另53例单纯高血压患者归为对照组。比较2组的性别、年龄、吸烟史、体质比、病程等基线资料,分析2组的空腹血糖、血脂、尿酸、颈动脉内膜中层厚度(IMT)及动态血压参数。结果与对照组比较,观察组的平均年龄、男性比例、有吸烟史患者的比例、IMT、24h平均收缩压、24h平均脉压、白昼平均收缩压、夜间平均收缩压及晨峰血压值均高于对照组(均P<0.05);观察组血压晨峰现象发生率高于对照组(23.08%比7.55%,χ~2=4.446,P<0.05);Logistic逐步回归分析显示年龄及晨峰血压是中年高血压合并脑梗死的独立危险因素(χ~2=5.809、6.168,P<0.05)。结论晨峰血压是中年原发性高血压患者发生脑梗死的独立危险因素,临床上应重视患者的血压晨峰现象,积极预防,合理降压治疗,以降低发生脑梗死的风险。

Objective To explore the relationship between morning blood pressure surge and cerebral infarction in middle-aged essential hypertensive patients.Methods A total of 92 middleaged patients were divided into control group（53 cases of essential hypertension）and observation group（39 cases of essential hypertension complicated by cerebral infarction）.The gender,age,smoking history,body mass index,disease course,fasting blood glucose,blood lipids,uric acid,carotid intima-media thickness（IMT）and dynamic blood pressure parameters were compared between the two groups.Results Compared with control group,the average age,ratio of male to female,proportion of patients with a history of smoking,IMT,24-hour mean systolic blood pressure,24-hour mean pulse pressure,daytime mean systolic blood pressure,nighttime mean systolic blood pressure,and morning blood pressure surge significantly increased in observation group（P〈0.05）.Furthermore,the incidence of morning blood pressure surge in observation group was higher than that in control group（23.08% vs 7.55%,χ^2=4.446,P〈0.05）.Logistic stepwise regression analysis showed that the age and morning blood pressure peak were independent risk factors for hypertension complicated by cerebral infarction in middle-aged patients（χ^2=5.809、6.168,P〈0.05）.Conclusion Morning blood pressure peak is an independent risk factors for cerebral infarction in patients with essential hypertension.Clinical doctors should pay attention to the morning surge in blood pressure and perform the prevention and treatment of hypertension to reduce the risk of cerebral infarction.