Relationship between gestational body mass index,blood pressure variability,and postpartum depression in pregnant women with preeclampsia

BACKGROUND Pre-eclampsia has long been proven to be an independent risk factor for postpartum depression(PPD).Excessive increase in body mass index(BMI)during pregnancy is an important factor inducing pre-eclampsia.Increased blood pressure is the main symptom of patients with pre-eclampsia.However,whether there is a correlation between BMI and blood pressure variability during pregnancy and PPD occurrence in pregnant women with pre-eclampsia remains unclear.AIM To investigate the relationship between BMI,blood pressure variability,and PPD in pregnant women with pre-eclampsia.METHODS Using a cross-sectional survey research,201 pregnant women with pre-eclampsia who were treated and delivered in Suzhou Ninth People’s Hospital from May 2016 to June 2024 were selected as this study’s subjects.At 42 days after delivery,the subjects were re-examined in the hospital’s outpatient department.The Edinburgh Postnatal Depression Scale(EPDS)was used to evaluate whether PPD symptoms,divided the subjects into two groups:The PPD and non-PPD groups.We analyzed clinical data,changes in BMI during pregnancy,and blood pressure variability in the two groups.The Pearson method was used to test the correlation between BMI increase,blood pressure variability during pregnancy,and EPDS score in patients with pre-eclampsia.Logistic regression analysis was performed to explore whether increased BMI and blood pressure variability during pregnancy are influencing factors for PPD occurrence in patients with pre-eclampsia.RESULTS Of the 201 pre-eclamptic women who underwent an outpatient review 42 days after delivery,37 had PPD symptoms based on the EPDS scale evaluation,resulting in an incidence rate of 18.41%(37/201).The differences between the PPD and non-PPD groups in terms of age,educational level,place of residence,reproductive history,gestational age,mode of delivery,newborn gender,and newborn birth weight were not statistically significant(P>0.05).The gestational BMI increase,24-hour systolic blood pressure(SBP)variability,and 24-hour diastolic blood pressure(DBP)variability in the PPD group were significantly higher than those in the non-PPD group;the differences were statistically significant(P<0.001).Pearson correlation analysis showed that BMI increase,SBP variability,and DBP variability during pregnancy correlated positively with the EPDS score of pregnant women with pre-eclampsia(r=0.349,0.336,and 0.241;P<0.001).Logistic regression analysis showed that a high increase in BMI during pregnancy[odds ratio(OR)=4.614,95%confidence interval(CI):1.749-12.170,P=0.002],large variability in 24-hour SBP(OR=2.910,95%CI:1.322-6.404,P=0.008),and large variability in 24-hour DBP(OR=2.347,95%CI:1.138-4.831,P=0.021)were factors affecting PPD occurrence in patients with pre-eclampsia.CONCLUSION Increased BMI and blood pressure variability during pregnancy can increase the risk of PPD in patients with preeclampsia.Strengthening pregnancy guidance and controlling fluctuations in BMI and blood pressure variability during pregnancy within a reasonable range can help reduce the risk of PPD in patients with pre-eclampsia.

Visit-to-visit Systolic Blood Pressure Variability and Stroke Risk: A Systematic Review and Meta-analysis

Visit-to-visit variability in systolic blood pressure(SBP)may have an important additional role in increasing the risk of vascular complications,including stroke.We conducted a meta-analysis to assess the relationship between visit-to-visit SBP variability(SBPV)and stroke risk.PubMed,EMBASE,and the Cochrane library databases were searched for cohort studies with data on visit-to-visit SBPV and stroke risk.Studies that reported adjusted relative risks(RRs)with 95%Cis of stroke associated with SBPV were included.Fourteen cohort studies met the inclusion criteria and were included in our meta-analysis.After adjustment for age,sex,and existing vascular risk factors,the analysis showed that the risk of stroke in patients with SBPV was significantly increased compared with patients with a small baseline SBPV[SD(RR=1.20,95%CI=(1.07-1.35),P=0.0005),CV(RR=1.12,95%CI=(1.00-1.26),P=0.008)].In addition,follow-up variations of more than 5 years were associated with a higher risk of stroke than those of less than 5 years[RR=1.08,95%CI=(1.04-1.11)].Visit-to-visit SBPV was associated with an increased risk of stroke,especially in terms of the time of variation.Taken together,SBPV data may be useful as a preventative diagnostic method in the management of stroke.

Significance of blood pressure variability in patients with sepsis

BACKGROUND: This study was undertaken to observe the characteristics of blood pressure variability(BPV) and sepsis and to investigate changes in blood pressure and its value on the severity of illness in patients with sepsis.METHODS: Blood parameters, APACHE II score, and 24-hour ambulatory BP were analyzed in 89 patients with sepsis.RESULTS: In patients with APACHE II score>19, the values of systolic blood pressure(SBPV), diasystolic blood pressure(DBPV), non-dipper percentage, cortisol(COR), lactate(LAC), platelet count(PLT) and glucose(GLU) were significantly higher than in those with APACHE II score ≤19(P<0.05), whereas the values of procalcitonin(PCT), white blood cell(WBC), creatinine(Cr), PaO2, C-reactive protein(CRP), adrenocorticotropic hormone(ACTH) and tumor necrosis factor α(TNF-α) were not statistically significant(P>0.05). Correlation analysis showed that APACHE II scores correlated significantly with SBPV and DBPV(P<0.01, r=0.732 and P<0.01, r=0.762). SBPV and DBPV were correlated with COR(P=0.018 and r=0.318; P=0.008 and r=0.353 respectively). However, SBPV and DBPV were not correlated with TNF-α, IL-10, and PCT(P>0.05). Logistic regression analysis of SBPV, DBPV, APACHE II score, and LAC was used to predict prognosis in terms of survival and non-survival rates. Receiver operating characteristics curve(ROC) showed that DBPV was a better predictor of survival rate with an AUC value of 0.890. However, AUC of SBPV, APACHE II score, and LAC was 0.746, 0.831 and 0.915, respectively.CONCLUSIONS: The values of SBPV, DBPV and non-dipper percentage are higher in patients with sepsis. DBPV and SBPV can be used to predict the survival rate of patients with sepsis.

Psychological stress and long-term blood pressure variability of military young males:The cardiorespiratory fitness and hospitalization events in armed forces study

BACKGROUND Acute stress might increase short-term heart rate variability and blood pressure variability(BPV);however,chronic stress would not alter short-term BPV in animal models.AIM To examine the association of psychological stress with long-term BPV in young male humans.METHODS We prospectively examined the association of chronic psychological stress with long-term BPV in 1112 healthy military males,averaged 32.2 years from the cardiorespiratory fitness and hospitalization events in armed forces study in Taiwan.Psychological stress was quantitatively evaluated with the Brief Symptom Rating Scale(BSRS-5),from the least symptom of 0 to the most severe of 20,and the five components of anxiety,insomnia,depression,interpersonal sensitivity,and hostility(the severity score in each component from 0 to 4).Longterm BPV was assessed by standard deviation(SD)for systolic and diastolic blood pressure(SBP and DBP),and average real variability(ARV),defined as the average absolute difference between successive measurements of SBP or DBP,across four visits in the study period from 2012 to 2018(2012-14,2014-15,2015-16,and 2016-18).RESULTS The results of multivariable linear regressions showed that there were no correlations of the BSRS-5 score with SDSBP,SDDBP,ARVSBP,and ARVDBP after adjusting for all the covariates[β(SE):-0.022(0.024),-0.023(0.026),-0.001(0.018),and 0.001(0.020),respectively;P>0.05 for all].In addition,there were also no correlations between each component of the BSRS score and the long-term BPV indexes.CONCLUSION Our findings suggest that chronic psychological stress might not be associated with long-term BPV in military young male humans.

The Effect of Baroreflex Function on Blood Pressure Variability

Objective: The aim of this study was to assess the relationship of blood pressure variability (BPV) and heart rate variability (HRV) to investigate the effect of baroreflex function on blood pressure variability. Methods: This study consisted of 111 subjects, including 32 normotensives and 79 hypertensives. All the subjects were given two concurrent tests: 24-hour Holter ECG and ambulatory blood pressure monitoring. According to standard deviation of normal-to-normal sinus RR intervals (SDNN) derived from the Holter ECG, the hypertensives were divided into two groups: an HRV normal group with SDNN > 100 ms and an HRV abnormal group with

Visit-to-Visit Blood Pressure Variability Are Associated with an Imbalance between Sympathetic and Parasympathetic Tone in Hypertensive Patients

Greater fluctuations in office blood pressure increase the risk of stroke and blood pressure volatility is an important risk factor for cardiovascular events. Effects of sympathetic and parasympathetic nerve on blood pressure regulation are well known, however, those on visit-to visit variation remains unclear. Aim of this study is to clarify the contribution of sympathetic and parasympathetic balance on blood pressure fluctuation. Methods: We enrolled 23 outpatients with essential hypertension. We measured blood pressure, and pulse rate at clinic 14 times in a row and calculated coefficient of variance (CV) as visit-to-visit variability. The velocity of pupil contraction, miosis (VC) and dilation, mydriasis (VD) was determined from pupillary function test. Results: Systolic blood pressure and diastolic blood pressure were not significantly correlated with VC, VD and VD/VC. Heart rate was not correlated with VC and VD, but significantly correlated with VD/VC. CV of systolic blood pressure, diastolic blood pressure and heart rate were not significantly correlated with VC or VD. Ratio of VD to VC significantly negative correlated with CV of blood pressure, diastolic blood pressure, and heart. Value of VD was significantly correlated with value of VC. Conclusion: Visit-to-visit variability of blood pressure and heart rate is not related with sympathetic or parasympathetic tone independently but augmented by the impaired sympathetic and parasympathetic balance.

Metabolic biomarkers and long-term blood pressure variability in military young male adults

BACKGROUND Metabolic syndrome is a cluster of cardiovascular risk factors, including central obesity, high blood pressure, elevated plasma glucose, reduced high-density lipoprotein and elevated triglyceride levels.AIM To investigate the relationship between metabolic biomarkers and long-term blood pressure variability(BPV) in young males.METHODS A cohort of 1112 healthy military males aged 18-40 years from the cardiorespiratory fitness and hospitalization events in armed forces study in eastern Taiwan was prospectively included. The following metabolic biomarkers were used: Waist circumference, serum uric acid(SUA), triglycerides, high density lipoprotein, triglycerides, and fasting glycose. BPV was assessed by average real variability(ARV) and standard deviation(SD) across 4 clinic visits during the study period(2012-14, 2014-15, 2015-16, and 2016-18). Multivariable linear regression analysis was used to determine the association after adjusting for age, body mass index, systolic and diastolic blood pressure(SBP and DBP),lipid profiles, physical activity, alcohol intake and tobacco smoking status.RESULTS In the unadjusted model, waist circumference was significantly and positively correlated with ARVDBP and SDDBP [β(standard errors) = 0.16(0.049) and 0.22(0.065), respectively], as was SUA [β = 0.022(0.009) and 0.038(0.012),respectively]. High-density lipoprotein was negatively correlated with ARVSBP [β=-0.13(0.063)]. There were no associations with the other metabolic biomarkers.In contrast, only SUA was significantly correlated with SDSBP and SDDBP [β = 0.019(0.011) and 0.027(0.010), respectively] in the adjusted model.CONCLUSION Our findings showed that of traditional metabolic biomarkers, SUA had the strongest positive correlation with long-term systolic and diastolic BPV in young male adults, and the clinical relevance needs further investigation.

Determinants of Blood Pressure Variability in Individuals with Essential Hypertension: A Survey-Based Study

Background: Blood pressure variability (BPV) in hypertensive patients is implicated as a remarkable feature leading to additional cardiovascular complications. The aim of the study was to identify the determinants influencing BPV among patients with essential hypertension seen at the Cardiology department of the faculty of medicine, University of Alexandria, Egypt. Methods: This was a descriptive cross-sectional hospital-based study conducted from August 2019 to November 2019. All the eligible patients were made to fill out a standard questionnaire to obtain family and personal clinical history and undergo routine physical examination, laboratory tests and 24-hour ambulatory blood pressure monitoring. BPV was summarized as the standard deviation (SD) of all-day systolic and diastolic BP in both normal patients (with SD 11) and abnormal patients (with SD ≥ 11). Results: Out of a total of 114 patients, 18 (15.8%) non-hypertensive patients were included in the control group and the remaining 96 (84.3%) were classified based on the degree of hypertension. BPV in all these patients was found to be significantly related to the male gender, a mild or moderate degree of hypertension, high prevalence of non-dipping, diabetes, use of beta-blockers as antihypertensive medication, heart rate variability, BMI, and increased day-time variability. Conclusion: Variability in blood pressure influenced by different intrinsic and extrinsic factors plays an important role in the management of hypertension. In order to reduce the burden of disease and for a better quality of life for hypertensive patients, it is important that physicians start considering lowering BPV in addition to reducing physiological BP levels.

Cardiovascular age of aviation personnel: based on the principal component analysis of heart rate and blood pressure variability

Objective: To introduce a method to calculate cardiovascular age, a new, accurate and much simpler index for assessing cardiovascular autonomic regulatory function, based on statistical analysis of heart rate and blood pressure variability (HRV and BPV) and baroreflex sensitivity (BRS) data. Methods: Firstly, HRV and BPV of 89 healthy aviation personnel were analyzed by the conventional autoregressive (AR) spectral analysis and their spontaneous BRS was obtained by the sequence method. Secondly, principal component analysis was conducted over original and derived indices of HRV, BPV and BRS data and the relevant principal components, PCi orig and PCi deri (i=1, 2, 3,...) were obtained. Finally, the equation for calculating cardiovascular age was obtained by multiple regression with the chronological age being assigned as the dependent variable and the principal components significantly related to age as the regressors. Results: The first four principal components of original indices accounted for over 90% of total variance of the indices, so did the first three principal components of derived indices. So, these seven principal components could reflect the information of cardiovascular autonomic regulation which was embodied in the 17 indices of HRV, BPV and BRS exactly with a minimal loss of information. Of the seven principal components, PC2 orig , PC4 orig and PC2 deri were negatively correlated with the chronological age ( P <0 05), whereas the PC3 orig was positively correlated with the chronological age ( P <0 01). The cardiovascular age thus calculated from the regression equation was significantly correlated with the chronological age among the 89 aviation personnel ( r =0.73, P <0 01). Conclusion: The cardiovascular age calculated based on a multi variate analysis of HRV, BPV and BRS could be regarded as a comprehensive indicator reflecting the age dependency of autonomic regulation of cardiovascular system in healthy aviation personnel.

Day-to-day blood pressure variability predicts poor outcomes following percutaneous coronary intervention:A retrospective study

BACKGROUND For patients with cardiovascular disease,blood pressure variability(BPV),distinct from hypertension,is an important determinant of adverse cardiac events.Whether pre-operative BPV adversely affects outcomes after percutaneous coronary intervention(PCI)is to this point unclear.AIM To investigate the relationship between blood pressure variability and outcomes for patients post-PCI.METHODS Patients undergoing PCI in a single state in 2017 were studied(n=647).Systolic and diastolic BPV,defined as both the largest change and standard deviation for the 3-60 mo prior to PCI was calculated and patients with more than ten blood pressure measurements in that time were included for analysis(n=471).Adverse outcomes were identified up to a year following the procedure,including major adverse cardiac events(MACE),myocardial infarction,cerebrovascular accident,death,and all-cause hospitalization.RESULTS Visit-to-visit systolic BPV,as measured by both standard deviation and largest change,was higher in patients who had myocardial infarction,were readmitted,or died within one year following PCI.Systolic BPV,as measured by largest change or standard deviation,was higher in patients who had MACE,or readmissions(P<0.05).Diastolic BPV,as measured by largest change,was higher in patients with MACE and readmissions(P<0.05).CONCLUSION As BPV is easily measured and captured in the electronic medical record,these findings describe a novel method of identifying at-risk patients who undergo PCI.Aggressive risk modification for patients with elevated BPV and known coronary artery disease is indicated.

Spectral Analysis of Blood Pressure Variability as a Quantitative Indicator of Driving Fatigue

The quantitative detector of driver fatigue presents appropriate warnings and helps to prevent traffic accidents.The aim of this study was to quantifiably evaluate driver mental fatigue using the power spectral analysis of the blood pressure variability (BPV) and subjective evaluation. In this experiment twenty healthy male subjects were required to perform a driving simulator task for 3-hours. The physiological variables for evaluating driver mental fatigue were spectral values of blood pressure variability (BPV)including very low frequency (VLF), low frequency (LF),high frequency (HF). As a result, LF, HF and LF/HF showed high correlations with driver mental fatigue but not found in VLF. The findings represent a possible utility of BPV spectral analysis in quantitatively evaluating driver mental fatigue.

Analysis of the relationship between blood pressure variability and subtle cognitive decline in older adults

BACKGROUND Blood pressure variability(BPV)has been shown to be related to mild cognitive impairment and Alzheimer's disease in a number of studies.However,the relationship between BPV and subtle cognitive decline(SCD)has received minimal attention in this field of research to date and has rarely been reported.AIM To examine whether SCD is independently associated with changes in BPV in older adults.METHODS Participants were selected based on having participated in cognitive function evaluation and ambulatory blood pressure measurement at the Shanghai Sixth People's Hospital Affiliated with Shanghai Jiao Tong University School of Medicine between June 2020 and August 2022.The participants included 182 individuals with SCD as the experimental group and 237 with normal cognitive function as the control group.The basic data,laboratory examinations,scale tests,and ambulatory blood pressure test results of the two groups were analyzed retrospectively,and the relationship between SCD and BPV was subsequently evaluated.RESULTS Significant differences were observed between the two groups of participants(P<0.05)in terms of age,education level,prevalence rate of diabetes,fasting blood glucose level,24-h systolic blood pressure standard deviation and coefficient of variation,24-h diastolic blood pressure standard deviation and coefficient of variation.The scale monitoring results showed significant differences in the scores for memory,attention,and visual space between the experimental and control groups.Logistic regression analysis indicated that age,education level,blood sugar level,and BPV were factors influencing cognitive decline.Linear regression analysis showed that there was an independent correlation between blood pressure variation and SCD,even after adjusting for related factors.Each of the above differences was still significant.CONCLUSION This study suggests that increased BPV is associated with SCD.

Blood Pressure Variability and Its Relationship with Cognitive Function in Elderly Patients with Essential Hypertension and Type 2 Diabetes

Objective: To investigate blood pressure variability of Elder hypertensives with type 2 diabetes and its relationship with cognition. Methods: A total of 143 elderly hypertensives were enrolled and divided into diabetic group (59 cases) and non-diabetic group (84 cases). The difference of general clinical characteristics, biochemical parameters, carotid ultrasound, a neuropsychological Scales and 24-hour ambulatory blood pressure (24hABPM) parameters between the two groups of subjects were compared. Then, the two groups (diabetic group and non-diabetic group) were further divided into (Mild cognitive dysfunction) subgroup (MMSE>26) and normal cognition subgroup (MMSE≤26), respectively. On the basis of MMSE scores, the difference of the parameters of ABPM between the two subgroups was analyzed. Results: Compared with the control group, 24hSBP, 24hPP, dSBP, dPP, nSBP, nPP, 24hSSD, dSSD, nSSD, 24hSCV, dSCV and nSCV were significantly higher in the diabetic group (p<0.05). However, cognition was lower in the diabetic group. No significant difference was found in the circadian pattern of blood pressure between the two groups. 24hSSD, dSSD, nSSD, 24hSCV, dSCV, nSCV were significantly higher in the MCI subgroup than normal cognition subgroup in both diabetic and non-diabetic groups(p<0.05), and they were negatively associated with scores of MMSE, the correlation coefficient were -0.235,-0.246,-0.341,-0.158,-0.222,-0.238 (0.001≤P<0.05). Conclusion: The study showed that in the elderly with hypertension, the mean systolic blood pressure and blood pressure variability were both higher in the diabetic group, and the cognition was lower instead. Whether or not with diabetes, blood pressure variability was always higher in the MCI subgroup. Blood pressure variability increased in patients with diabetes, and was associated with cognitive decline.

S5A-3 Increased Blood Pressure Variability Impairs Memory in Rats

Background and Objective:Increased blood pressure variability(BPV),which has been considered to cause brain damage,can be induced by sinoaortic denervation(SAD)in rats.This study was designed to test the hypothesis that increased BPV impairs learning and memory in rats with SAD.Methods:SAD was performed in male Sprague-Dawley rats.Passive avoidance trial was used to evaluate learning and memory ability.Results:Compared with shamoperated(Sham)group,there was no significant difference in the latency of passive avoidance in adaption trial.The latency of avoiding darkness in retention trial in SAD group was significantly lower than that in Sham group both 2 and 16 weeks after SAD(P<0.05,P<0.01).Westernblot assay revealed that all the expression of choline acetyltransferase,vesicular acetylcholine transporter andα7 nicotinic acetylcholine receptor decreaed in both cerebral cortex(P<0.05)and hippocampus(P<0.05)16 weeks after SAD(P<0.05),while only level ofα7 nicotinic acetylcholine receptor was reduced in hippocampus 2 weeks after SAD(P<0.05).Conclusion:Increasd BPV reduces memory ability in SAD rats,potentially through cholinergic pathway.

Effects of Impaired Glucose Metabolism on Heart Rate Variability and Blood Pessure Variability in Essential Hpertensive Patients

To investigate the effects of impaired glucose metabolism （IGM） on cardiovascular autonomic nervous systems in essential hypertensive （EH） patients by comparing heart rate variability （HRV） and blood pressure variability （BPV） in EH patients with or without type 2 diabetes mellitus （T2DM）. Simultaneous 24-h recordings of ambulatory ECG and blood pressure monitoring were performed in 36 male old patients with simple EH and 33 male old patients with EH combined with T2DM. HRV analysis included time domain parameters such as SDNN, SDANN, SDNNi, rMSSD and pNN50, and total spectral power （TP） of HRV, which mainly consists of VLF, LF and HF component along with LF/HF ratio, was also obtained. The value of ambulatory blood pressure was represented as the mean blood pressure （mean systolic/mSBP, diastolic/mDBP and pulse pressure/mPP） during different periods （24 h/24 h, day time/d and night time/n）. Standard deviation （SD） as well as coefficient of variance （CV） of blood pressure during each above-mentioned period were obtained to reflect the long-term BPV. Our result showed that SDNN, SDNNi, SDANN, rMSSD, PNN50, TP and HF of HRV in cases of EH with T2DM were all significantly lower than those in simple EH subjects （P〈0.05）. No significant differences in VLF or LF was found between the two groups （P〉0.05）, while LF/HF ratio was significantly higher in EH with T2DM patients than in simple EH subjects （P〈0.01）. Moreover, dmSBP, 24 h-mPP and dmPP were all significantly higher in EH with T2DM patients than in simple EH subjects （P〈0.05）, while nmSBP, 24 h-mSBP, 24 h-mDBP, dmDBP, nmDBP or nmPP showed no significant difference between this two groups of patients （P〉0.05）. And dSBPSD, dSBPCV and 24 h-SBPSD were all significantly higher in EH with T2DM patients than in simple EH subjects （P〈0.05）, while the other BPV indexes showed no significant difference between this two groups （P〉0.05）. It is concluded that the cardiovascular autonomic nervous systems in EH patients was further impaired by T2DM, displaying lowering of HRV and enlargement of BPV, which in turn induced abnormal structural and functional changes of cardiovascular systems. Therefore, improving cardiovascular autonomic nervous systems might reduce the occurrence of cardiovascular complications in the EH patients with IGM.

NT-proBNP、Hcy联合BPV对子痫前期孕妇不良妊娠结局的预测价值

目的探讨N末端B型脑钠肽前体(NT-proBNP)、同型半胱氨酸(Hcy)联合动态血压变异性(BPV)对子痫前期(PE)孕妇妊娠结局的预测价值。方法选取2020年10月至2023年10月广东省中山市小榄人民医院收治的PE孕妇203例为研究对象,根据妊娠结局分为结局良好组(n=129)和结局不良组(n=74)。比较2组的临床特征,分析影响PE孕妇不良妊娠结局的危险因素,以及NT-proBNP、Hcy联合BPV对PE孕妇不良妊娠结局的预测价值。结果结局良好组的血小板计数高于结局不良组,NT-proBNP、Hcy水平低于结局不良组(P<0.05)。结局良好组的收缩压变异性(SBPV)、舒张压变异性(DBPV)小于结局不良组(P<0.05)。Logistic回归分析显示,NT-proBNP、Hcy、SBPV、DBPV为PE孕妇不良妊娠结局的独立危险因素(P<0.05),血小板计数是PE孕妇不良妊娠结局的保护因素。受试者工作特征(ROC)曲线分析显示,NT-proBNP、Hcy、SBPV、DBPV预测PE患者不良妊娠结局的曲线下面积(AUC)分别为0.719、0.851、0.864、0.923,联合预测的AUC为0.962,敏感度为0.973,特异度为0.946。结论NT-proBNP、Hcy水平升高和BPV增大是PE孕妇不良妊娠结局的影响因素,NT-proBNP、Hcy联合BPV对PE孕妇妊娠结局具有良好的预测价值。

青少年时期血压轨迹及血压变异性与靶器官损害相关性的队列研究

目的探讨中国人群儿童期至中年期的血压轨迹及血压变异性与靶器官损伤发生风险的相关性。方法本研究为基于人群的长期随访队列研究。入选1987—2023年在汉中青少年高血压队列中至少进行了5次血压测量的参与者作为研究对象。采用基于群组的轨迹模型识别不同的收缩压和舒张压轨迹, 并根据血压轨迹将入选研究对象分为低增长组、中增长组和高增长组。通过标准差、独立于均值的变异性(VIM)和平均真实的变异性(ARV)等指标评估血压变异性, 在2023年末次随访时(中年期)评估靶器官损伤。采用logistic回归模型分析血压轨迹及血压变异性与靶器官损伤发生风险的关系。结果共入选2 447名研究对象, 中位年龄48岁, 男性1 373人(56.1%)。分组结果为:(1)根据收缩压:低增长组868人, 中增长组1 238人, 高增长组341人;(2)根据舒张压:低增长组894人, 中增长组1 263人, 高增长组290人。与收缩压低增长组相比, 收缩压中增长组(动脉硬化:OR=4.14, 95%CI 2.96~5.79;蛋白尿:OR=2.06, 95%CI 1.38~3.07;左心室肥厚:OR=1.68, 95%CI 1.00~2.82)和高增长组(动脉硬化:OR=15.44, 95%CI 10.14~23.50;蛋白尿:OR=5.80, 95%CI 3.63~9.29;左心室肥厚:OR=2.93, 95%CI 1.55~5.53)的靶器官损伤发生风险更高(P均<0.05)。舒张压中增长组较低增长组动脉硬化(OR=3.72, 95%CI 2.69~5.12)和蛋白尿(OR=1.67, 95%CI 1.15~2.42)的发生风险更高(P均<0.05), 而高增长组各靶器官损伤发生风险均较低增长组更高(动脉硬化:OR=10.84, 95%CI 7.08~16.61;蛋白尿:OR=3.72, 95%CI 2.31~5.99;左心室肥厚:OR=2.38, 95%CI 1.23~4.59;P均<0.05)。此外, 较高的收缩压变异性与动脉硬化(标准差:OR=2.25, 95%CI 1.96~2.57;VIM:OR=1.64, 95%CI 1.45~1.86;ARV:OR=1.70, 95%CI 1.50~1.93)和蛋白尿(标准差:OR=1.65, 95%CI 1.44~1.89;VIM:OR=1.41, 95%CI 1.22~1.63;ARV:OR=1.45, 95%CI 1.26~1.67)的发生风险增加相关(P均<0.05)。舒张压相关变异性指标与靶器官损伤相关性的分析结果与收缩压相似。结论生命早期血压轨迹与中年期靶器官损害的发生风险相关。较高的血压变异性与动脉硬化和蛋白尿的发生风险增加相关, 但与左心室肥厚的相关性较弱。关注生命早期的高血压风险有助于预防中年期靶器官损害的发生。

缬沙坦联合氨氯地平对原发性高血压患者的BPV的影响及其作用机制

目的探讨缬沙坦联合氨氯地平治疗原发性高血压患者的降压效果、对患者血压变异性的影响及其作用机制。方法选取2010年1月-2015年12月于海门市第四人民医院心血管内科治疗的140例原发性高血压患者进行研究,随机分为试验组和对照组,试验组70例采用缬沙坦联合氨氯地平治疗,对照组70例采用缬沙坦联合氢氯噻嗪治疗,分别在治疗6周、12周后对比两组患者的血压控制效果、血压变异性、血浆一氧化氮（NO）、内皮素（ET）水平。结果治疗前、治疗6周、12周后,两组患者的24 h平均收缩压（24 h SBP）、24 h平均舒张压（24 h DBP）、日间收缩压（d SBP）、日间舒张压（d DBP）、夜间收缩压（n SBP）、夜间舒张压（n DBP）,指标差异均无统计学意义（P〉0.05）;治疗6周、12周后,试验组患者24 h收缩压变异性（24 h SBPV）、24 h舒张压变异性（24 h DBPV）,显著低于对照组（P〈0.05）,试验组的ET低于对照组、NO高于对照组,差异均有统计学意义（P〈0.05）;两组血压达标率比较,差异无统计学意义（84.29%vs.80.00%,P〉0.05）。结论缬沙坦联合氨氯地平治疗原发性高血压的疗效与缬沙坦联合氢氯噻嗪效果相近,但是能够更好的减低血压变异性,其作用机制可能与改善血管内皮功能有关。

原发性高血压患者血清TGF-β1水平对血压BPV及昼夜节律的影响研究

目的探讨原发性高血压(EH)患者血清转化生长因子β1(TGF-β1)水平对血压变异性(BPV)及昼夜节律的影响。方法将2016年8月至2018年10月收治的118例EH患者纳入观察组,同时,将同期体检的120例健康人群纳入对照组;对比2组血清TGFβ-1水平,血压BPV及血压昼夜节律。结果观察组血清TGF-β1明显高于对照组(P<0.05)。观察组24 h SBP、dSBP、nSBP、mSBP均明显高于对照组,而其24 h DBP、dDBP、nDBP、mDBP均明显低于对照组(P<0.05)。观察组24 h SBPV、24 h DBPV、nDBPV、mSBPV与对照组相比差异有统计学意义(P<0.05)。观察组不同水平血清TGF-β1 BPV差异有统计学意义(P<0.05);且观察组血清TGF-β1与24 h SBPV、mSBPV呈正相关(r=0.541,0.5552;P均<0.05),而与24 h DBPV、nDBPV呈负相关(r=-0.477,-0.468;P均<0.05)。观察组发生昼夜节律异常率为95.76%,对照组发生昼夜节律异常率为56.67%,差异有统计学意义(P<0.05)。结论EH患者血清TGF-β1水平明显较高,BPV在一定范围高于正常人群,昼夜节律异常率较高,且其血清TGF-β1水平与BPV具有相关性。

高血压飞行员BPV、HRV及相互关系分析

目的探讨安静状态下高血压飞行员血压变异性(BPV)与心率变异性(HRV)的变化关系。方法对53名鉴定为飞行合格的高血压飞行员进行24hAMBP监测,用一元线性相关与回归对24h及昼、夜的收缩压变异性(SSD)、舒张压变异性(DSD)、HRV均值进行综合分析,并比较昼、夜SSD、DSD、HRV差异和心率的变异程度(CV)。结果 24h及昼夜SSD、DSD、HRV值均呈正态分布,P>0.05,各变异均值之间(除昼间SSD和DSD)高度相关,两变异值间有简单的回归方程关系,对回归方程F值检验,P<0.05,方程均成立。各回归方程中两变异值的相关系数R特点为:夜、昼SSD之R值最大,SSD与HRV高于DSD与HRV之R值,夜间R值高于昼间。昼、夜SSD差异明显,P<0.05;昼、夜DSD、HRV差异不明显,P>0.05;收缩压CV低于舒张压和心率的CV。结论高血压飞行员SSD、DSD、HRV高度相关,应注意高血压事件的预防。