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(...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.展开更多
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
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. Meth...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展开更多
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 ...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.展开更多
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 psy...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.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
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...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.展开更多
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...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.展开更多
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 diabet...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.展开更多
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 analys...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.展开更多
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 bloo...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.展开更多
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 th...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.展开更多
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 va...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.展开更多
Background:Although multiple measures of blood pressure variability(BPV)have been proposed,whether they are better than mean blood pressure in predicting target organs is unclear.We aimed to determine the relationship...Background:Although multiple measures of blood pressure variability(BPV)have been proposed,whether they are better than mean blood pressure in predicting target organs is unclear.We aimed to determine the relationship between short term BPV and target organ injury.Methods:This study was a retrospective study,and 635 inpatients in the Department of Cardiology from 2015 to 2020 were selected.We divided participants into four groups on the basis of the quartiles of BPV.One-way analysis of variance was used to compare the differences between the groups,and linear regression was used to analyze the relationship between BPV and target organ damage.Results:The average age of 635 patients was 74.36±6.50 years old.Among them,354 of 627 patients had diminished renal function(56.5%),221of 604 patients had associated left ventricular hypertrophy(36.6%),and 227 of 231 patients had carotid plaque formation(98.3%).The baseline data indicated significant differences in fasting glucose,total cholesterol,low-density lipoprotein,creatinine,glomerular filtration rate,sex,calcium channel blocker use,and the rate of diminished renal function.Multiple linear regression analysis showed that BPV was negatively correlated with renal injury(creatinine:r=0.306,p<0.01;estimated glomerular filtration rate:r=0.058,p<0.01),and BPV is positively correlated with cardiac injury(r=0.083,p<0.01).Elevated BPV was not found to be associated with vascularinjury.Conclusion:Renal function decreases with increasing BPV and left ventricular mass increases with increasing BPV.展开更多
目的 探讨收缩压变异性(SBPV)和心率变异性(HRV)对维持性血液透析(MHD)患者主要不良心血管事件(MACE)发生风险的预测价值。方法 纳入2017年3月—2018年3月在宜昌市中心人民医院肾病内科血液净化中心接受规律治疗的MHD患者120例,根据是...目的 探讨收缩压变异性(SBPV)和心率变异性(HRV)对维持性血液透析(MHD)患者主要不良心血管事件(MACE)发生风险的预测价值。方法 纳入2017年3月—2018年3月在宜昌市中心人民医院肾病内科血液净化中心接受规律治疗的MHD患者120例,根据是否发生MACE分为MACE组(n=59)与无MACE组(n=61)。在患者行血液透析前佩戴Holter,收集24 h心电活动信息,计算均值(MEAN)、RR间期总体标准差(SDNN)、RR间期平均值的标准差(SDANN)和相邻RR间期差值的均方根(r-MSSD)。采用自动血压监测系统记录24 h血压变化,计算白昼收缩压变异性(dSBPV)、夜间收缩压变异性(nSBPV)和24 h收缩压变异性(24 h SBPV)。Logistic回归分析MHD患者MACE发生的危险因素。调整混杂因素后,采用Cox比例风险模型回归分析24 h SBPV和SDNN与MHD患者MACE发生的关系。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)、灵敏度、特异度,分析SDNN和收缩压变异性单独及联合对维持性MHD患者发生MACE的预测价值。根据SDNN和24 h SBPV水平将患者分成3组,绘制Kaplan-Meier生存曲线评价不同SDNN和收缩压变异性的MHD患者MACE发生情况。结果 与无MACE组相比,MACE组年龄较大,24 h SBPV、dSBPV、nSBPV较高,SDNN、SDANN较低,差异具有统计学意义(P<0.05)。Logistic回归分析显示,年龄、Kt/V、24 h SBPV、dSBPV、nSBPV、SDNN、SDANN是MHD患者MACE发生的独立危险因素(P<0.05)。调整混杂因素后,多因素COX比例风险模型回归分析,24 h SBPV为MHD患者发生MACE的危险因素,而SDNN为MHD患者发生MACE的保护性因素(P<0.05)。SDNN与收缩压变异性联合预测MHD患者发生MACE的AUC为0.879,预测效能高于单项检测(P<0.05)。组1随访期间累积MACE发生率显著低于组2和组3(19.15%vs 65.12%vs 73.33%,P<0.001)。结论 MHD不良预后患者中24 h SBPV升高,SDNN降低,24 h SBPV和SDNN单独预测MACE的具体价值尚可,两者联合预测效果更佳,可为临床上及早识别及干预MHD患者MACE发生提供参考依据。展开更多
为研究北京市科技工作者精神压力与心脏损伤的关系,以155名北京市科技工作者为研究对象,测量相关指标。结果表明,样本群体中心血管疾病占比20.6%,抑郁占比35.9%,焦虑占比24.8%,失眠占比38.8%。在应对精神压力应激时,科技工作者血压、心...为研究北京市科技工作者精神压力与心脏损伤的关系,以155名北京市科技工作者为研究对象,测量相关指标。结果表明,样本群体中心血管疾病占比20.6%,抑郁占比35.9%,焦虑占比24.8%,失眠占比38.8%。在应对精神压力应激时,科技工作者血压、心率均较静息时明显升高,心率变异性指标中SDNN(Standard deviation of NN intervals,RR间期标准差)下降、LF/HF(low frequency/high frequency,低高频比值)升高,反映样本群体在精神压力应激时心脏交感副交感神经失衡。通过远程心电监测,发现科技工作者在居家时存在异常心电活动,包括各类心律失常、心电图ST-T改变(ST为心室肌除极过程,T为心室肌复极过程)等。基于以上结果,建议定期给科技工作者提供心脏心理的检测,必要时提供远程的心电监测,及时发现科技工作者的心脏心理问题,对有必要进行干预的人员,及早提供干预措施,以保障科技工作者的心脏心理健康。展开更多
基金Shanghai Municipal Commission of Science and Technology Program,No.19411960900.
文摘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.
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
文摘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.
基金the Hualien Armed Forces General Hospital Grant,No.HAFGH-D-109007.
文摘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.
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.
基金Supported by Hualien Armed Forces General Hospital,No.805-C109-07.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
基金This work was supported by the Natural Science Foundation of Shandong Province of China(ZR2014HQ007,ZR2017MH048),the Foundation of Overseas Distinguished Taishan Scholars of Shandong Province of China(to H-TZ)and Collaborative Innovation Center for Research and Development of Traditional Chinese Medicine in Mount Tai.
文摘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.
文摘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.
基金Science and Technology Plan of Beijing Tongzhou,Grant/Award Number:KJ2022CX036Summit Talent Plan,Beijing Hospital Management Center,Grant/Award Number:DFL20190101。
文摘Background:Although multiple measures of blood pressure variability(BPV)have been proposed,whether they are better than mean blood pressure in predicting target organs is unclear.We aimed to determine the relationship between short term BPV and target organ injury.Methods:This study was a retrospective study,and 635 inpatients in the Department of Cardiology from 2015 to 2020 were selected.We divided participants into four groups on the basis of the quartiles of BPV.One-way analysis of variance was used to compare the differences between the groups,and linear regression was used to analyze the relationship between BPV and target organ damage.Results:The average age of 635 patients was 74.36±6.50 years old.Among them,354 of 627 patients had diminished renal function(56.5%),221of 604 patients had associated left ventricular hypertrophy(36.6%),and 227 of 231 patients had carotid plaque formation(98.3%).The baseline data indicated significant differences in fasting glucose,total cholesterol,low-density lipoprotein,creatinine,glomerular filtration rate,sex,calcium channel blocker use,and the rate of diminished renal function.Multiple linear regression analysis showed that BPV was negatively correlated with renal injury(creatinine:r=0.306,p<0.01;estimated glomerular filtration rate:r=0.058,p<0.01),and BPV is positively correlated with cardiac injury(r=0.083,p<0.01).Elevated BPV was not found to be associated with vascularinjury.Conclusion:Renal function decreases with increasing BPV and left ventricular mass increases with increasing BPV.
文摘目的 探讨收缩压变异性(SBPV)和心率变异性(HRV)对维持性血液透析(MHD)患者主要不良心血管事件(MACE)发生风险的预测价值。方法 纳入2017年3月—2018年3月在宜昌市中心人民医院肾病内科血液净化中心接受规律治疗的MHD患者120例,根据是否发生MACE分为MACE组(n=59)与无MACE组(n=61)。在患者行血液透析前佩戴Holter,收集24 h心电活动信息,计算均值(MEAN)、RR间期总体标准差(SDNN)、RR间期平均值的标准差(SDANN)和相邻RR间期差值的均方根(r-MSSD)。采用自动血压监测系统记录24 h血压变化,计算白昼收缩压变异性(dSBPV)、夜间收缩压变异性(nSBPV)和24 h收缩压变异性(24 h SBPV)。Logistic回归分析MHD患者MACE发生的危险因素。调整混杂因素后,采用Cox比例风险模型回归分析24 h SBPV和SDNN与MHD患者MACE发生的关系。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)、灵敏度、特异度,分析SDNN和收缩压变异性单独及联合对维持性MHD患者发生MACE的预测价值。根据SDNN和24 h SBPV水平将患者分成3组,绘制Kaplan-Meier生存曲线评价不同SDNN和收缩压变异性的MHD患者MACE发生情况。结果 与无MACE组相比,MACE组年龄较大,24 h SBPV、dSBPV、nSBPV较高,SDNN、SDANN较低,差异具有统计学意义(P<0.05)。Logistic回归分析显示,年龄、Kt/V、24 h SBPV、dSBPV、nSBPV、SDNN、SDANN是MHD患者MACE发生的独立危险因素(P<0.05)。调整混杂因素后,多因素COX比例风险模型回归分析,24 h SBPV为MHD患者发生MACE的危险因素,而SDNN为MHD患者发生MACE的保护性因素(P<0.05)。SDNN与收缩压变异性联合预测MHD患者发生MACE的AUC为0.879,预测效能高于单项检测(P<0.05)。组1随访期间累积MACE发生率显著低于组2和组3(19.15%vs 65.12%vs 73.33%,P<0.001)。结论 MHD不良预后患者中24 h SBPV升高,SDNN降低,24 h SBPV和SDNN单独预测MACE的具体价值尚可,两者联合预测效果更佳,可为临床上及早识别及干预MHD患者MACE发生提供参考依据。
文摘为研究北京市科技工作者精神压力与心脏损伤的关系,以155名北京市科技工作者为研究对象,测量相关指标。结果表明,样本群体中心血管疾病占比20.6%,抑郁占比35.9%,焦虑占比24.8%,失眠占比38.8%。在应对精神压力应激时,科技工作者血压、心率均较静息时明显升高,心率变异性指标中SDNN(Standard deviation of NN intervals,RR间期标准差)下降、LF/HF(low frequency/high frequency,低高频比值)升高,反映样本群体在精神压力应激时心脏交感副交感神经失衡。通过远程心电监测,发现科技工作者在居家时存在异常心电活动,包括各类心律失常、心电图ST-T改变(ST为心室肌除极过程,T为心室肌复极过程)等。基于以上结果,建议定期给科技工作者提供心脏心理的检测,必要时提供远程的心电监测,及时发现科技工作者的心脏心理问题,对有必要进行干预的人员,及早提供干预措施,以保障科技工作者的心脏心理健康。