原发性高血压患者臂间收缩压差与左心室质量指数的相关性研究

Relationship between interarm difference in systolic pressure and left ventricular mass index in patients with essential hypertension

目的:探讨原发性高血压患者臂间收缩压差(IADSBP)升高与左心室质量指数(LVMI)的相关性。方法:选取住院的469例原发性高血压患者的临床资料进行回顾性分析。根据双上臂IADSBP将患者分为IADSBP正常组(IADSBP<10 mmHg,1mmHg=0.133 kPa)和IADSBP升高组(IADSBP≥10 mm Hg)。比较两组一般资料、实验室指标、24 h动态血压监测参数和LVMI,分析IADSBP升高与LVMI的相关性及其影响因素。结果:IADSBP升高组BMI大、血肌酐更高、饮酒比例少(均P<0.05)。IADSBP升高组的24 h平均收缩压、24 h平均舒张压及24 h平均心率高于IADSBP正常组,差异均有统计学意义(均P<0.05);且在日间及夜间的平均收缩压、舒张压及心率中的表现均保持一致(均P<0.05)。IADSBP升高组LVMI显著高于IADSBP正常组[(120.8±28.4)vs.(113.3±28.3)g/m^(2),P=0.044]。进行多元线性回归分析结果显示:IADSBP、BMI、TC是影响LVMI的主要因素。结论:IADSBP升高与LVMI增加相关。应注重双臂血压的测量促进高血压的有效管理,减少心血管事件的发生。

Objective:To investigate the relationship between left ventricular mass index(LVMI)and interarm systolic pressure gradient(IADSBP)in patients with essential hypertension(EH).Methods:The clinical data of 469 hospitalized patients with EH were retrospectively analyzed.The patients were divided into normal IADSBP group(IADSBP<10 mm Hg,1 mmHg=0.133 kPa)and elevated IADSBP group(IADSBP≥10 mm Hg)according to the bilateral upper arm IADSBPs.The general data,laboratory parameters,24-hour ambulatory blood pressure monitoring parameters and LVMI were compared between the two groups,and the correlation between elevated IADSBP and LVMI and its influencing factors were analyzed.Results:Patients with elevated IADSBP had higher BMI,higher Scr and less drinking ratio(all P<0.05).The 24-hour average systolic blood pressure,24-hour average diastolic blood pressure and 24-hour average heart rate in the elevated IADSBP group were higher than those in the normal IADSBP group,and the differences were statistically significant(all P<0.05);and the average systolic blood pressure,diastolic blood pressure and heart rate in the daytime and nighttime were consistent with those in 24-hour(all P<0.05).LVMI was significantly higher in the elevated IADSBP group than in the normal IADSBP group[(120.8±28.4)vs.(113.3±28.3)g/m^(2),P=0.044].Multiple linear regression analysis showed that IADSBP,BMI and total cholesterol were the main factors affecting LVMI.Conclusions:Elevated IADSBP is associated with increased LVMI.Measuring blood pressure in both arms would promote the management of hypertension and reduce cardiovascular events.