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...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.展开更多
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...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.展开更多
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 inf...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.展开更多
目的:探讨颈动脉支架术前24 h动态血压变异性(BPV)与术后颈动脉窦反应(CSR)之间的关系,以期寻找具有预测CSR及类型的BPV指标。方法:纳入行颈动脉起始部支架置入术的颈动脉狭窄病人59例,根据CSR的定义分为CSR组和非CSR组,进一步将CSR组...目的:探讨颈动脉支架术前24 h动态血压变异性(BPV)与术后颈动脉窦反应(CSR)之间的关系,以期寻找具有预测CSR及类型的BPV指标。方法:纳入行颈动脉起始部支架置入术的颈动脉狭窄病人59例,根据CSR的定义分为CSR组和非CSR组,进一步将CSR组病人分别归类为低血压型、心动过缓型以及混合型三种亚型。使用无创性便携式血压监测仪监测术前24 h血压变化,比较病人24 h、日间和夜间平均收缩压(MSBP)、舒张压(MDBP),以及各自的标准差(SD)和变异系数(CV)。结果:59例病人中25例未发生CSR,34例发生CSR,其中低血压型19例,心动过缓型8例,混合型7例。CSR组病人的高血压、吸烟史和血管狭窄程度均高于非CSR病人组(P<0.05),高血压为CSR的独立风险因素(P<0.01)。CSR病人24 h MDBP、DBP-SD/CV、SBP-SD/CV均高于非CSR病人(P<0.01),同时2组病人日间、夜间SBP-SD/CV和DBP-SD/CV差异均有统计学意义(P<0.01),进一步分析显示24 h SBP和DBP的SD和CV均与病人术后CSR的发生呈正相关关系(P<0.01)。单因素方差分析显示,混合型CSR病人24 h DBP的CV高于低血压型和心动过缓型病人(P<0.05),混合型日间和夜间SBP的SD和CV均高于低血压型和心动过缓型(P<0.05),在夜间混合型病人的DBP的SD和CV也均高于低血压型病人(P<0.05)。多元logistic回归显示,24 h DBP的CV以及日间和夜间的SBP的SD/CV均是混合型的独立风险因素(P<0.05)。结论:颈动脉支架术前BPV与CSR的发生及类型相关,提示BPV可作为预测病人术后发生特定类型CSR的指标。展开更多
目的探讨高血压患者左室整体长轴收缩期峰值应变(GLPS)与动态血压水平及血压变异性(BPV)的关系。方法选取原发性高血压既往未行降压治疗患者79例,以GLPS绝对值20%为界分为GLPS下降组42例和GLPS正常组37例。采用全自动生化分析仪、彩色...目的探讨高血压患者左室整体长轴收缩期峰值应变(GLPS)与动态血压水平及血压变异性(BPV)的关系。方法选取原发性高血压既往未行降压治疗患者79例,以GLPS绝对值20%为界分为GLPS下降组42例和GLPS正常组37例。采用全自动生化分析仪、彩色多普勒超声、动态血压监测仪分别检测两组血清生化指标、心脏功能、左侧肱动脉24 h血压;采用多元线性逐步回归分析方法明确GLPS的独立相关因素。结果两组比较,血清甘油三酯、总胆固醇(TC)、低密度脂蛋白胆固醇水平、心脏舒张末期室间隔厚度、左室重量指数以及全天平均收缩压(24 h SBP)、日间平均收缩压、全天收缩压变异系数、全天舒张压变异系数、夜间舒张压变异系数(n DBPCV)差异均有统计学意义(P<0.05或<0.01)。多元线性逐步回归分析显示,24 h SBP(β=-0.083,P<0.01)、n DBPCV(β=-8.730,P<0.05)、TC(β=-0.366,P<0.05)与GLPS独立相关。结论高血压GLPS下降患者24 h SBP、n DBPCV升高,此种变化可引起左室早期收缩功能障碍。展开更多
基金The study was supported by grants from the National Natural Science Foundation of China(No.81760221 and No.81660209)National Science&Technology Foundational Resource Investigation Program of China(No.2018FY100900)the Major Program of the Natural Science Foundation of Jiangxi Province(No.2016ACB20015).
文摘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.
文摘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.
文摘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.
文摘目的:探讨颈动脉支架术前24 h动态血压变异性(BPV)与术后颈动脉窦反应(CSR)之间的关系,以期寻找具有预测CSR及类型的BPV指标。方法:纳入行颈动脉起始部支架置入术的颈动脉狭窄病人59例,根据CSR的定义分为CSR组和非CSR组,进一步将CSR组病人分别归类为低血压型、心动过缓型以及混合型三种亚型。使用无创性便携式血压监测仪监测术前24 h血压变化,比较病人24 h、日间和夜间平均收缩压(MSBP)、舒张压(MDBP),以及各自的标准差(SD)和变异系数(CV)。结果:59例病人中25例未发生CSR,34例发生CSR,其中低血压型19例,心动过缓型8例,混合型7例。CSR组病人的高血压、吸烟史和血管狭窄程度均高于非CSR病人组(P<0.05),高血压为CSR的独立风险因素(P<0.01)。CSR病人24 h MDBP、DBP-SD/CV、SBP-SD/CV均高于非CSR病人(P<0.01),同时2组病人日间、夜间SBP-SD/CV和DBP-SD/CV差异均有统计学意义(P<0.01),进一步分析显示24 h SBP和DBP的SD和CV均与病人术后CSR的发生呈正相关关系(P<0.01)。单因素方差分析显示,混合型CSR病人24 h DBP的CV高于低血压型和心动过缓型病人(P<0.05),混合型日间和夜间SBP的SD和CV均高于低血压型和心动过缓型(P<0.05),在夜间混合型病人的DBP的SD和CV也均高于低血压型病人(P<0.05)。多元logistic回归显示,24 h DBP的CV以及日间和夜间的SBP的SD/CV均是混合型的独立风险因素(P<0.05)。结论:颈动脉支架术前BPV与CSR的发生及类型相关,提示BPV可作为预测病人术后发生特定类型CSR的指标。
文摘目的探讨高血压患者左室整体长轴收缩期峰值应变(GLPS)与动态血压水平及血压变异性(BPV)的关系。方法选取原发性高血压既往未行降压治疗患者79例,以GLPS绝对值20%为界分为GLPS下降组42例和GLPS正常组37例。采用全自动生化分析仪、彩色多普勒超声、动态血压监测仪分别检测两组血清生化指标、心脏功能、左侧肱动脉24 h血压;采用多元线性逐步回归分析方法明确GLPS的独立相关因素。结果两组比较,血清甘油三酯、总胆固醇(TC)、低密度脂蛋白胆固醇水平、心脏舒张末期室间隔厚度、左室重量指数以及全天平均收缩压(24 h SBP)、日间平均收缩压、全天收缩压变异系数、全天舒张压变异系数、夜间舒张压变异系数(n DBPCV)差异均有统计学意义(P<0.05或<0.01)。多元线性逐步回归分析显示,24 h SBP(β=-0.083,P<0.01)、n DBPCV(β=-8.730,P<0.05)、TC(β=-0.366,P<0.05)与GLPS独立相关。结论高血压GLPS下降患者24 h SBP、n DBPCV升高,此种变化可引起左室早期收缩功能障碍。
