Objective: To investigate the correlation between morning blood pressure surge, homocysteine (Hcy) and left ventricular hypertrophy (LVH) in elderly patients with primary hypertension. Method: 215 cases of patients wi...Objective: To investigate the correlation between morning blood pressure surge, homocysteine (Hcy) and left ventricular hypertrophy (LVH) in elderly patients with primary hypertension. Method: 215 cases of patients with hypertension from January 2015 to June 2016 were randomly selected from TianYou Hospital attached to WUST.Blood pressure was monitored 24 hours;according to the results, patients were divided into 81 cases of morning blood pressure surge group (study group) and 134 cases of non-morning blood pressure surge group (control group). Biochemical indicators of the two groups were measured, such as Hcy, Glu, blood lipid (TC, TG, LDL-C, HDL-C). The ventricular structure index (IVST, LVDD, LVPWT, LVMI) were measured by color doppler ultrasound.Result: 1) The IVST, LVDD, LVPWT and LVMI were significantly higher in study group than in control group (P 0.05), and the incidence of left ventricular hypertrophy (LVH) (74.1%) was significantly higher in study group than in control group (22.4%) (P 0.05). 2) There was no statistical difference in TC, TG, LDL-C and HDL-C between the two groups (P > 0.05). The serum levels of Hcy [(16.89 ± 5.84) mmol/L] in study group were significantly higher than those in control group [(10.88 ± 4.07) mmol/L] (P 0.05). 3) Multivariate logistic regression analysis showed that morning blood pressure surge and Hcy were the risk factors of left ventricular hypertrophy. Conclusion: In elderly patients with?hypertension, the higher the morning blood pressure surge and Hcy level, the more probability of left ventricular hypertrophy and the more obvious degree.展开更多
目的 探讨小剂量左旋氨氯地平、替米沙坦及氢氯噻嗪同时与不同时给药对轻中度高血压患者血压晨峰（MBPS）的影响.方法 选择我院2011年5月至2014年5月门诊及住院的高血压患者138例,男性86例,女性52例.入选者收缩压（SBP）＜180 mm Hg,舒...目的 探讨小剂量左旋氨氯地平、替米沙坦及氢氯噻嗪同时与不同时给药对轻中度高血压患者血压晨峰（MBPS）的影响.方法 选择我院2011年5月至2014年5月门诊及住院的高血压患者138例,男性86例,女性52例.入选者收缩压（SBP）＜180 mm Hg,舒张压（DBP）91～109 mm Hg,年龄＞45岁,24 h动态血压监测（ABDM）具有MBPS现象.随机分为2组：Ⅰ组（不同时给药组,70例）晨服替米沙坦40 mg和氢氯噻嗪10 mg,晚服左旋氨氯地平2.5 mg;Ⅱ组（同时给药组,68例）以上三种药物均晨服.所有病例治疗前及治疗8周后进行ABPM监测.结果 治疗8周后,Ⅰ组和Ⅱ组的24h SBP/DBP均较治疗前分别降低17.34/10.26 mm Hg和16.64/10.42 mm Hg,日间SBP/DBP分别降低15.48/9.86 mm Hg和17.36/10.28 mm Hg,均较治疗前明显降低（P＜0.01）,两组间降低幅度未见统计学差异（P＞0.05）.两组夜间SBP/DBP分别降低21.52/11.22 mm Hg和15.82/10.14 mm Hg,均较治疗前明显降低（P＜0.01）;Ⅰ组治疗后降低幅度较Ⅱ组明显,两组比较差异有统计学意义（P＜0.05）.治疗前与治疗8周后清晨收缩压差值（MSBPD）Ⅰ组分别为（37.26±10.34）mm Hg和（23.14±7.82）mm Hg,治疗后显著降低（P＜0.01）;Ⅱ组分别为（37.48±10.32）mm Hg和（29.34±8.46）mmHg,治疗后明显降低（P＜0.05）,两组治疗后比较,差异有统计学意义（P＜0.05）.结论 对于晨峰高血压患者,小剂量左旋氨氯地平、替米沙坦及氢氯噻嗪无论同时还是不同时给药均能有效控制24h、日间和夜间血压;而不同时给药治疗夜间血压优于同时给药,尤其控制MBPS现象更明显.展开更多
文摘Objective: To investigate the correlation between morning blood pressure surge, homocysteine (Hcy) and left ventricular hypertrophy (LVH) in elderly patients with primary hypertension. Method: 215 cases of patients with hypertension from January 2015 to June 2016 were randomly selected from TianYou Hospital attached to WUST.Blood pressure was monitored 24 hours;according to the results, patients were divided into 81 cases of morning blood pressure surge group (study group) and 134 cases of non-morning blood pressure surge group (control group). Biochemical indicators of the two groups were measured, such as Hcy, Glu, blood lipid (TC, TG, LDL-C, HDL-C). The ventricular structure index (IVST, LVDD, LVPWT, LVMI) were measured by color doppler ultrasound.Result: 1) The IVST, LVDD, LVPWT and LVMI were significantly higher in study group than in control group (P 0.05), and the incidence of left ventricular hypertrophy (LVH) (74.1%) was significantly higher in study group than in control group (22.4%) (P 0.05). 2) There was no statistical difference in TC, TG, LDL-C and HDL-C between the two groups (P > 0.05). The serum levels of Hcy [(16.89 ± 5.84) mmol/L] in study group were significantly higher than those in control group [(10.88 ± 4.07) mmol/L] (P 0.05). 3) Multivariate logistic regression analysis showed that morning blood pressure surge and Hcy were the risk factors of left ventricular hypertrophy. Conclusion: In elderly patients with?hypertension, the higher the morning blood pressure surge and Hcy level, the more probability of left ventricular hypertrophy and the more obvious degree.
文摘目的 探讨小剂量左旋氨氯地平、替米沙坦及氢氯噻嗪同时与不同时给药对轻中度高血压患者血压晨峰（MBPS）的影响.方法 选择我院2011年5月至2014年5月门诊及住院的高血压患者138例,男性86例,女性52例.入选者收缩压（SBP）＜180 mm Hg,舒张压（DBP）91～109 mm Hg,年龄＞45岁,24 h动态血压监测（ABDM）具有MBPS现象.随机分为2组：Ⅰ组（不同时给药组,70例）晨服替米沙坦40 mg和氢氯噻嗪10 mg,晚服左旋氨氯地平2.5 mg;Ⅱ组（同时给药组,68例）以上三种药物均晨服.所有病例治疗前及治疗8周后进行ABPM监测.结果 治疗8周后,Ⅰ组和Ⅱ组的24h SBP/DBP均较治疗前分别降低17.34/10.26 mm Hg和16.64/10.42 mm Hg,日间SBP/DBP分别降低15.48/9.86 mm Hg和17.36/10.28 mm Hg,均较治疗前明显降低（P＜0.01）,两组间降低幅度未见统计学差异（P＞0.05）.两组夜间SBP/DBP分别降低21.52/11.22 mm Hg和15.82/10.14 mm Hg,均较治疗前明显降低（P＜0.01）;Ⅰ组治疗后降低幅度较Ⅱ组明显,两组比较差异有统计学意义（P＜0.05）.治疗前与治疗8周后清晨收缩压差值（MSBPD）Ⅰ组分别为（37.26±10.34）mm Hg和（23.14±7.82）mm Hg,治疗后显著降低（P＜0.01）;Ⅱ组分别为（37.48±10.32）mm Hg和（29.34±8.46）mmHg,治疗后明显降低（P＜0.05）,两组治疗后比较,差异有统计学意义（P＜0.05）.结论 对于晨峰高血压患者,小剂量左旋氨氯地平、替米沙坦及氢氯噻嗪无论同时还是不同时给药均能有效控制24h、日间和夜间血压;而不同时给药治疗夜间血压优于同时给药,尤其控制MBPS现象更明显.
