血压升高对不同性别心血管靶器官的影响

Effects of Elevated Blood Pressure on Cardiovascular Target Organs in Different Genders

目的:探讨血压升高对不同性别心血管靶器官的影响。方法:男性受试者共247例,血压正常(NBP)组113例,血压升高(EBP)组134例;女性受试者共239例,NBP组90例,EBP组149例。分别检测肱踝脉搏波传导速度(baPWV)、踝臂指数(ABI)及颈动脉内-中膜厚度(IMT),并行超声心动图检查。结果:EBP组中,男性左房内径(LAd)、左心室舒张末期内径(LVEDd)均较NBP组明显增大(P<0.05);舒张末期室间隔厚度(IVSd)及左心室后壁厚度(LVPWd)均较NBP组明显增厚(P<0.05);左心室每搏量(SV)、心输出量(CO)及左室心肌质量(LVM)均较NBP组明显增加(P<0.05)。EBP组中,女性LAd较NBP组明显增大(P<0.05);SV及CO均较NBP组明显增加(P<0.05)。EBP组中男性LAd、LVEDd、IVSd、LVPWd、LVM及CO均明显高于女性(P<0.05)。与NBP组比较,EBP组男性和女性的baPWV均明显增快(P<0.05);而ABI均明显低于NBP组(P<0.05);与NBP组比较,EBP组男性颈动脉IMT明显增厚(P<0.05)。EBP组中男性ABI低于女性(P<0.05),男性颈动脉IMT厚于女性(P<0.05)。结论:血压升高对男性及女性受试者心脏表型的主要不同影响在于:男性血压升高的左室壁较血压正常明显增厚,且LAd、LVEDd、LVM均明显增大,而女性仅LAd增大。血管表型差异则为血压升高的男性的颈动脉IMT较血压正常的明显增厚,对女性无明显影响。

Objective:To investigate the effect of elevated blood pressure on cardiovascular target organs of different genders.Method:There were a total of 247 male subjects,113 cases in the NBP group and 134 cases in the EBP group,there were 239 female subjects,90 cases in the NBP group and 149 cases in the EBP group.Brachial pulse wave conduction velocity (baPWV),ankle-brachial index (ABI) and carotid intima-media thickness (IMT) were detected,and echocardiography was performed.Result:In the EBP group,the LAd and LVEDd of men were significantly increased compared with those of the NBP group (P<0.05);both IVSd and LVPWd were significantly thicker than those of the NBP group (P<0.05);SV,CO and LVM all increased significantly compared with the NBP group (P<0.05).In the EBP group,the LAd of the women was significantly larger than that of the NBP group (P<0.05);both SV and CO increased significantly compared with the NBP group (P<0.05).LAd,LVEDd,IVSd,LVPWd,LVM and CO in the EBP group were significantly higher than those in the women (P<0.05).Compared with the NBP group,baPWV increased significantly in both men and women in the EBP group (P<0.05);ABI was significantly lower than that of NBP group (P<0.05);compared with the NBP group,the carotid artery IMT in the EBP group was significantly thickened (P<0.05).ABI of male was lower than that of female in the EBP group (P<0.05),carotid artery IMT in male was thicker than that in female (P<0.05).Conclusion:The main differences between the cardiac phenotypes of male and female subjects with elevated blood pressure were as follows:the left ventricular wall of the male subjects with elevated blood pressure was significantly thicker than the normal blood pressure,and the LAd,LVEDd and LVM were significantly increased,while the LAd of the female subjects was only increased.The vascular phenotypic difference is that the carotid artery IMT of the men with elevated blood pressure is significantly thicker than that of the normal blood pressure and had no significant effect on the women.