原发性高血压病患者动态血压变异性对左心室肥厚和尿微量白蛋白影响的临床研究

目的:观察老年原发性高血压病患者血压变异性(BPV)对心脏结构和肾功能损伤影响。方法:根据夜间血压下降率将患者分为年龄、性别相匹配的两组,夜间血压下降率<10%为非杓型组,≥10%为杓型组。应用24小时动态血压监测和超声心动图方法观察并比较200例原发性高血压病患者的动态血压节律及左心室厚度、尿微量白蛋白的特点。结果:非杓型组24小时收缩压、24小时舒张压、夜间收缩压、夜间舒张压明显高于杓型组,两组比较差异有显著性(P<0.05)。结论:非杓型组高血压患者的血压节律类型较杓型组者更易导致左心室肥厚及肾功能减退。

老年原发性高血压病患者动态血压变异性对心脏结构和肾功能损伤的临床研究

目的观察老年原发性高血压病患者血压变异性（BPV）对心脏结构和肾功能损伤影响。方法根据夜间血压下降率将患者分为年龄、性别相匹配的两组,夜间血压下降率〈10%为非杓型组,≥10%为杓型组。应用24小时动态血压监测和超声心动图方法观察并比较200例原发性高血压病患者的动态血压节律及心脏结构、肾功能的特点。结果非杓型组24h收缩压、24h舒张压、夜间收缩压、夜间舒张压明显高于杓型组,非杓型组夜间血压变异显著高于杓型组,非杓型组左室重量指数高于杓型组,肾功能尿系列蛋白检出率非杓型组均显著高于杓型组。结论非杓型组高血压病人的血压节律类型较杓型组者更易导致左心室肥厚及肾功能减退。

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.

Genetic variations of beta 2-adrenergic receptor gene are associated with essential hypertension in Xinjiang Kazakans

Objective The aims of the present study were to investigate the associations of 46 A〉G, 79 C〉G, 491 C〉T and 659 C〉G genetic variants of the human beta 2-adrenergic receptor （β2-AR）, ADRB2, gene with essential hypertension （EH） in Xinjiang Kazakans population.Methods A gender-matched case-control （271 hypertensive cases and 267 normotensive controls） study was used to investigate the associations of the four variations in the coding region of ADRB2 with EH. The genotypes of the variants were identified by the polymerase chain reaction and restriction fragment length polymorphism （PCR-RFLP） methods. Results 46 A〉G, 79 C〉G and 659 C〉G polymorphisms were common in the Kazakan population, but 491 C〉T was a mutation （frequency ofT allele was only 0.003） and only found in EH group. The fxequency distributions of genotypes and alleles for 659 C〉G between the EH and control groups was significantly different （P〈0.05）, while those for 46 A〉G and 79 C〉G polymorphisms were not statistically different. Logistic regression analysis suggested that the G allele of 659 C〉G polymorphism was a risk factor for hypertension （minor allele vs common homo; odds ratio, 13.240, 95% CI, 4.052-43.274; P〈0.05）. Covariance analysis showed that systolic and diastolic blood pressure levels in GG＋CG group of 659 C〉G were significantly higher than those in the CC group, but no significant difference of blood pressure were found between common homo and minor allele for 46 A〉G and 79C〉G polymorphisms. Haplotype analysis showed that two hyplotypes, HI： 46A-79C-491C-523C（48%）and H5：46A-79C-491C-659G, were associated with EH.Conelusion ADRB2 genetic variants may play independent roles in the molecular genetic mechanism of EH in Xinjiang Kazakans population （d Geriatr Cardio12010; 7：52-57）.

Effect of electroacupuncture at Qūchí (曲池 LI 11) and Tàichōng (太冲 LR 3) on blood pressure variability in young patients with hypertension

Objective To compare therapeutic effects of electroacupuncture and western medicine on blood pressure variability in young patients with hypertension. Methods Sixty cases of young patients of hypertension were randomly divided into an electroacupuncture group and a western medicine group, 30 cases in each group. In the electroacupuncture group, electroacupuncture was applied at Quchi （曲池LI 11） and Taichong （太冲LR 3）. In the western medicine group, Captopril was taken orally. Twenty-four hour dynamic blood pressure, and blood pressure variability and circadian rhythms were observed after treatment for 14 days in the two groups. Results Electroacupuncture at Quchi （曲池LI 11） and Taichong （太冲LR 3） significantly decreased systolic pressure and diastolic pressure at different time phases in the young patients with hypertension （all P〈0.01）, with no significant difference as compared with the western medicine group （all P〉0.05）; electroacupuncture at Quchi （曲池LI 11） and Taichong （太冲LR 3） significantly reduced the standard deviations of systolic pressure and diastolic pressure at different time phases in the young patients with hypertension as compared with those before the treatment （P〈0.01, P〈0.05）. There were statistically significant differences between the two groups in 24 h systolic standard deviation （24 h SSD）, 24 h diastolic standard deviation （24 h DSD）, daytime SSD （dSSD）, nighttime SSD （nSSD） and nighttime DSD （nDSD） （P〈0.01, P〈0.05）; and there was significant difference between the two groups in numbers of the Dipper and the non-Dipper after treatment （P〈0.05）. Conclusion Electroacupuncture at Quchi （曲池LI 11） and Taichong （太冲LR 3） has a better long-term effect of decreasing blood pressure and improves effectively changes of circadian rhythms in young patients with hypertension, which are an effective point pair for hypertension.