Effect of Bushen Hemai Decoction on vascular stiffness in elderly patients with isolated systolic hypertension

Objective: To investigate the effect of Bushen Hemai Decoction on the wall stiffness of middle-aged and elderly patients with isolated systolic hypertension. Methods: A total of 126 patients with middle and old systolic hypertension were selected from March 2017 to March 2018 in our hospital. According to the random table method, there were 63 cases in the observation group and 63 cases in the control group. The control group was treated with conventional western medicine, while the observation group was treated with kidney tonifying and pulse prescription hypothyroidism on the basis of the control group. The two groups were treated for 12 weeks. The changes of blood pressure, pulse conduction velocity and endothelium-dependent vasodilation function were compared between the two groups before and after treatment. Results: the systolic pressure in the two groups was lower than that before the treatment, but the diastolic pressure was not significantly changed, and the systolic pressure in the observation group was lower than that of the control group, while the diastolic pressure was not statistically significant. After treatment, the pulse conduction velocity of the two groups was lower than that before the treatment, and the pulse conduction velocity of the observation group was lower than that of the control group after treatment. After two groups of treatment, FMD was higher than before treatment, but there was no significant change in the diameter of vascular base, and FMD in the observation group was higher than that of the control group, but there was no statistical difference between the blood vessel base diameter. The total effective rate of the observation group (93.65%) was higher than that of the control group (74.60%). Conclusion: Bushen Hemai Decoction is effective in treating isolated systolic hypertension in middle-aged and old patients, and can reduce the stiffness of patients' tube wall, which is worthy of clinical reference.

Effect of Bushen Hemai decoction on vascular stiffness in elderly patients with isolated systolic hypertension

Objective: To investigate the effect of Bushen Hemai decoction on the wall stiffness of middle-aged and elderly patients with simple systolic hypertension. Methods: The 126 middle-aged and elderly patients with simple systolic hypertension admitted to our hospital from May 2010 to May 2015 were randomly divided into control group (63 cases) and observation group (63 cases). The control group was treated with conventional Western medicine, while the observation group was treated with Bushen Hemai decoction on the basis of the control group. The two groups were treated for 4 weeks. Results: The systolic blood pressure of the two groups decreased after treatment (observation group: T=16.165, control group: T=13.537, P<0.05);the systolic blood pressure of the two groups did not change significantly after treatment (observation group: T=1.857, control group: T=0.483, P>0.05);the systolic blood pressure of the observation group was lower than that of the control group after treatment (T=16.165, P<0.05). After treatment, the level of ST segment of ECG in the two groups was lower than that before treatment (observation group: T=22.145, control group: T=11.007, P<0.05);after treatment, the level of ST segment of ECG in the observation group was lower than that in the control group (T=8.130, P<0.05). After treatment, the pulse conduction velocity of the two groups was lower than that of the control group (observation group:T=8.694, control group: T=3.944, P<0.05);after treatment, the pulse conduction velocity of the observation group was lower than that of the control group (T=5.326, P<0.05). The total effective rate of the observation group (93.65%) was higher than that of the control group (76.19%) (P<0.05). Conclusion: Bushen Hemai Decoction has a significant clinical effect on middle-aged and elderly patients with simple systolic hypertension, and can improve the stiffness of the tube wall, which is worthy of clinical reference.

Influence of irbesartan combined with low dose urokinase on treatment effect and serologic indexes in elderlyisolated systolic hypertension patients

To study the influence of irbesartan combined with low dose urokinase on treatment effect and serologic indexes in elderly isolated systolic hypertension patients. Methods: One hundred and ten cases of elderly isolated systolic hypertension patients in our hospital during January 2013–January 2016 were randomly divided into observation group with 55 cases and control group with 55 cases. Patients in observation group received irbesartan combined with low dose hydrochlorothiazide treatment and those in control group received amlodipine combined with low dose hydrochlorothiazide treatment, each lasted for 4 weeks. After 4 weeks treatment, non-invasive blood pressure and blood pressure variability indexes were measured, serum endothelial function, inflammatory factors and oxidative stress indexes were measured. Results: After 4 weeks treatment, patients systolic blood pressure (SBP), 24 h mean systolic blood pressure (24 h SBP), 24 h systolic blood pressure standard deviation (24 h SSD) were significantly lower in observation group than in control group (P<0.05);serum endothelial function index EF-1 was lower in observation group than in control group, while NO and endothelial nitric oxide synthase (eNOS) were higher in observation group than in control group (P<0.05);serum high sensitivity C-reactive protein (hs-CRP), interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-α (TNF-α) contents were lower in observation group than in control group (P<0.05);serum oxidation index such as malondialdehyde (MDA) was lower in observation group than in control group, while antioxidant indexes such as total anti-oxidative capacity (TAC), superoxide dismutase (SOD), GSH were higher in observation group than in control group (P<0.05). Conclusions: Irbesartan combined with low dose hydrochlorothiazide can effectively reduce systolic hypertension and blood pressure variability in elderly isolated systolic hypertension patients, while optimizing the systemic inflammation and oxidative stress status.

Is Chinese Herbal Medicine Effective for Elderly Isolated Systolic Hypertension? A Systematic Review and Meta-Analysis

To study the efficacy of Chinese medicine (CM) on isolated systolic hypertension. Seven electronic databases were searched for randomized controlled trials (RCTs) published until August 2015. Subgroup analyses and meta-analysis were performed to assess the efficacy and safety of the included studies. A total of 24 studies, including 2,096 patients (1,058 patients in the intervention group and 1,038 in the control group), were evaluated in the final analysis. Compared with a conventional therapy used alone, CM as additional intervention was more effective on systolic blood pressure [mean difference (MD)=-0.66, 95% confidence interval (CI)=(-0.97,-0.36), P < 0.00001] and significantly diminished the pulse pressure [MD=-7.49, CI=(-12.69,-2.29), P < 0.00001]. However it showed no additional benefit on diastolic blood pressure [MD=1.16, CI=(0.02, 2.29), P=0.87]. Adverse events were not explicitly reported in most RCTs. CM might be a promising approach for the elderly with isolated systolic hypertension, while the evidence for CM employed alone was insufficient. Considering the inherent limitations of the included studies, larger high-quality RCTs with extensive follow-up should be performed to validate our findings in the future.

苯磺酸左旋氨氯地平联合依那普利治疗老年单纯收缩期高血压的效果及对血管内皮细胞功能的影响探析

目的 探析老年单纯收缩期高血压患者应用苯磺酸左旋氨氯地平联合依那普利治疗的临床效果及对血管内皮细胞功能的影响。方法 100例老年单纯收缩期高血压患者,遵循随机数字表设计方式将其分为对照组、观察组,每组50例。对照组给予依那普利治疗,观察组给予依那普利联合苯磺酸左旋氨氯地平治疗。对比两组患者血压[日间平均收缩压(DMSBP)、夜间平均收缩压(NMSBP)、24 h平均收缩压(24 h MSBP)]水平、临床疗效、内皮功能指标[一氧化氮(NO)、血流介导的血管扩张功能(FMD)、内皮素-1(ET-1)]。结果 治疗前,两组患者DMSBP、NMSBP、24 h MSBP无显著差异(P>0.05);治疗后,两组DMSBP、NMSBP、24 h MSBP均较治疗前有所改善,其中观察组DMSBP(120.52±10.01)mm Hg(1 mm Hg=0.133 kPa)、NMSBP(113.74±11.81)mm Hg、24 h MSBP(117.54±10.87)mm Hg均低于对照组的(138.45±12.35)、(132.63±12.70)、(134.02±12.58)(P<0.05)。观察组病情控制总有效率96.0%显著高于对照组的80.0%(P<0.05)。治疗前,两组患者NO、FMD、ET-1水平无显著差异(P>0.05);治疗后,两组NO、FMD、ET-1水平均较治疗前有所改善,其中观察组NO(6.25±1.39)μmol/L、FMD(7.68±1.13)%高于对照组的(5.61±1.25)μmol/L、(5.31±1.01)%, ET-1(60.84±10.48)ng/L低于对照组的(68.15±9.59)ng/L(P<0.05)。结论 对老年单纯收缩期高血压患者给予苯磺酸左旋氨氯地平片联合依那普利治疗效果良好,可有效改善患者血压水平及内皮功能,可于此类患者群体中推广。

Relationship between non-dipper hypertension and arteriosclerosis in the elderly

Objective To investigate the influence of non-dipper blood pressure rhythm on peripheral atherosclerosis in elderly hypertensive patients.Methods The 199 elderly hypertensive patients with 24-hour average systolic blood pressure【140 mmH g were selected.Body mass index(BMI),glycosylated hemoglobin,blood lipids,uric acid,creatinine,Brachial ankle pulse wave velocity(ba PWV),ankle arm index(ABI)and 24-hour ambulatory blood pressure monitoring were tested and calculated.The elderly patients were divided into dipper hypertensive group(n=95),and non-dipper

SGLT2i联合ARB对合并2型糖尿病的老年单纯收缩期高血压患者血压的影响分析

目的探讨钠-葡萄糖协同转运蛋白2抑制剂(sodium-dependent glucose transporter 2 inhibitor,SGLT2i)联合血管紧张素Ⅱ受体拮抗剂(angiotensinⅡreceptor blocker,ARB)对合并2型糖尿病的老年单纯收缩期高血压患者血压的影响。方法选取2019年9月至2022年9月于承德市中心医院心血管内科门诊就诊的合并2型糖尿病的老年单纯收缩期高血压患者150例为研究对象,根据随机数表法分为对照组(n=75)及实验组(n=75)。实验组采用厄贝沙坦150 mg/d联合达格列净10 mg/d口服治疗,对照组采用厄贝沙坦150 mg/d联合氢氯噻嗪12.5 mg/d口服治疗,对比两组治疗前后收缩压、脉压、平均动脉压、尿酸水平变化,分析两组肥胖改善率及治疗期间发生低钾血症和泌尿系感染的不良反应情况。结果治疗后,两组收缩压、脉压、平均动脉压均较治疗前降低且差异有统计学意义(P<0.05);在治疗12周后,实验组收缩压、脉压水平分别为(147.51±6.22)mmHg、(80.63±6.06)mmHg均低于对照组的(150.47±6.77)mmHg、(83.27±6.06)mmHg,差异具有统计学意义(P=0.006、P=0.008)。实验组肥胖改善率优于对照组(1 mmHg=0.133kPa),差异有统计学意义(P=0.034)。治疗期间实验组发生低钾血症概率低于对照组,差异有统计学意义(P=0.042)。结论SGLT2i联合ARB可有效降低合并2型糖尿病的老年单纯收缩期高血压患者的收缩压及脉压,且临床安全性可靠。

缬沙坦氨氯地平联合阿托伐他汀治疗老年顽固性单纯收缩期高血压的临床研究

目的探究缬沙坦氨氯地平联合阿托伐他汀治疗老年顽固性单纯收缩期高血压的临床效果。方法64例老年顽固性单纯收缩期高血压患者为研究对象,依据随机抽签法分为对照组和观察组,各32例。对照组采用缬沙坦氨氯地平治疗,观察组采用缬沙坦氨氯地平联合阿托伐他汀治疗。比较两组治疗效果,治疗前后血压水平及心脏超声指标[舒张末期室间隔厚度(IVST)、左室后壁厚度(PWT)、左室舒张末期内径(LVEDd)],不良反应发生情况。结果观察组治疗总有效率96.88%显著高于对照组的81.25%,差异有统计学意义(P<0.05)。治疗6个月后,观察组的收缩压(121.09±9.02)mmHg(1mm Hg=0.133 kPa)、IVST(8.31±1.00)mm、PWT(9.06±0.95)mm、LVEDd(51.19±1.77)mm均显著低于对照组的(134.47±9.57)mm Hg、(9.00±0.95)mm、(9.91±0.89)mm、(52.47±1.85)mm,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论缬沙坦氨氯地平联合阿托伐他汀治疗老年顽固性单纯收缩期高血压效果显著,可显著降低患者的收缩压水平,并有助于改善心室肥厚,对于改善患者预后具有积极的意义,值得推广应用。

比索洛尔和地尔硫?治疗老年单纯性收缩期高血压的有效性和安全性比较

目的比较比索洛尔和地尔硫治疗老年单纯性收缩期高血压的有效性和安全性。方法选取2018年1月至2021年1月就诊的90例老年单纯性收缩期高血压患者,采用随机数字表法将其分为比索洛尔组(45例,比索洛尔治疗)和地尔硫组(45例,地尔硫治疗)。比较两组的治疗效果。结果治疗后,地尔硫组的收缩压(SBP)、心率低于比索洛尔组,差异具有统计学意义(P<0.05);治疗后,两组的舒张压(DBP)比较,差异无统计学意义(P>0.05)。地尔硫组的治疗总有效率高于比索洛尔组,差异具有统计学意义(P<0.05)。治疗后1周,两组的超敏C反应蛋白(hs-CRP)、细胞间黏附因子-1(ICAM-1)和可溶性P-选择素(sP-sel)水平低于治疗前,且比索洛尔组低于地尔硫组,差异具有统计学意义(P<0.05)。地尔硫组的不良反应总发生率低于比索洛尔组,差异具有统计学意义(P<0.05)。结论地尔硫在改善老年单纯性收缩期高血压患者SBP、心率等方面效果更佳,不良反应发生率更低,但比索洛尔在抑制炎性反应方面更佳,因此临床需结合实际情况进行方案选取。

高血压的表现类型及临床特征分析

目的 研究上海社区人群的高血压患病率 ,各高血压亚组的临床特征及高血压发生的影响因素。方法 对 5 6 2 8例 2 0岁以上的社区人群进行血压、体重指数 (BMI)、血糖、血脂、胰岛素等测定 ,调查人群中共有高血压 2 173例 ,其中既往有明确高血压史 14 5 6例 ,新发高血压 717例 ,后者根据收缩压和舒张压值被分为单纯收缩期高血压组 (ISH)、单纯舒张期高血压组 (IDH)及收缩期高血压合并舒张期高血压组 (SH +DH) ;然后根据血糖值进一步将新发的高血压人群分成正常血糖组 (NGT)、糖调节受损组 (IGR)及糖尿病组 (DM )。结果 ①高血压的患病率为 38.6 1%。新发高血压者占高血压总人群的 33.0 0 %。新发高血压人群中ISH占 2 6 .2 2 % ,IDH占 4 1.70 % ,SH +DH占 32 .0 8%。②高血压各亚组的BMI、腰围 (W )、腰臀比 (WHR)、三酰甘油 (TG)、餐后2h血糖 (2hPG)均较正常血压组 (NBP)明显升高。③新发高血压者中ISH组年龄大 ,2hPG较高 ,但胰岛素抵抗较轻 ;IDH组年龄轻 ,较肥胖 ,胰岛素抵抗较重 ;而SH +DH组兼有年龄大、肥胖 (腹型肥胖 )及胰岛素抵抗更为严重等特点。④在糖代谢异常伴高血压者中 ,以ISH及SH +DH更为多见。结论 ①总体脂含量、体脂分布、血糖、血胰岛素、血脂是高血压发生的影响因素。

不同类型高血压人群与健康人群血脂和肾功能差异及血压影响因素分析

目的研究不同类型高血压人群血脂和肾功能差异及血压影响因素。方法选择2012年7月~2015年7月于中国中医科学院广安门医院南区的体检者1717例，详细记录病史、测量身高、体重、体质指数（BMI)、血压等，检测血常规、血液流变学等指标，应用BeckmanDXI-800全自动化学发光分析仪测定生化指标，包括三酰甘油（TG)、胆固醇（CHO)、高密度脂蛋白胆固醇（HDL-C)、低密度脂蛋白胆固醇（LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、尿素氮（Urea)、肌酐（Cr)、尿酸（UA)。并根据健康状态和血压值分为4组，健康组（1158例），双期高血压组（254例），单纯舒张期高血压组（89例），单纯收缩期高血压组（216例），将4组间的各项检测指标进行比较研究，并运用多元逐步回归分析得出血压的影响因素。结果健康组、双期高血压组、单纯舒张期高血压组、单纯收缩期高血压组受试者平均年龄分别为（36.71±10.23)岁、（46.35±10.72)岁、（44.85±9.34)岁、（46.57±7.68)岁。经单因素方差分析检验，双期高血压组、单纯舒张期高血压组的年龄、体重、BMI、收缩压、舒张压明显高于健康组（P<0.05)。而各组性别、身高、心率比较差异无统计学意义(P>0.05)。双期高血压组、单纯舒张期高血压组、单纯收缩期高血压组3组TG、CHO、Urea、Cr、UA均明显高于健康组（P<0.05);双期高血压组、单纯收缩期高血压组LDL-C明显高于健康组（P<0.05);双期高血压组、单纯舒张期高血压组LDL-C均明显低于单纯收缩期高血压组（P<0.05);双期高血压组UA明显高于单纯舒张期高血压组（P<0.05)。相关性分析：TG、CHO、LDL-C、Urea、Cr、UA均与收缩压呈显著正相关性，TG、CHO、Cr、UA均与舒张压呈显著正相关性。多元逐步回归分析显示：年龄、体重、BMI、TG、CHO、Cr、UA是收缩压的危险因素，而年龄、BMI、TG、CHO、LDL-C、Cr、UA是舒张压的危险因素。结论在临床治疗高血压过程中，除单纯的降压药治疗外，还应同时给予调节脂质代谢和肾脏代谢的药物，更重要的是需要区别对待不同类型的高血压患者，个体化治疗，才能获得更好的疗效，进而达到真正延缓高血压的发展进程。

硝酸酯类药物对老年单纯收缩期高血压的有益作用

目的 观察硝酸酯类药物对老年单纯收缩期高血压 (ISH)患者降压治疗的有益作用。方法 87例ISH患者随机分为对照组 4 6例和治疗组 4 1例 ,对照组给予非洛地平缓释片 5mg ,每日一次口服 ,治疗组在上述治疗的基础上给予加用单硝酸异山梨酯 (ISMN) 2 0mg ,每日二次口服 ,疗程8周。结果 (1)治疗组从第 2周开始收缩压 (SBP)下降幅度即大于对照组 ,且先于对照组于第 4周降至正常 ,差别有显著性 (P <0 0 5 ) ;(2 )从第 2周开始治疗组舒张压 (DBP)下降幅度即小于对照组(P <0 0 5 ) ,第 6周开始差距进一步加大 ,差别有显著性 (P <0 0 1) ,整个观察期内治疗组DBP下降幅度始终小于对照组 ,且从第 4周开始处于相对稳定状态 ;(3)第 2周开始治疗组PP下降幅度即大于对照组 (P <0 0 5 ) ,第 4周开始差距进一步加大 ,差别有显著性 (P <0 0 1)。结论 硝酸酯类药物能降低ISH患者的SBP ,而对DBP影响不大 ,使PP减小 ,对ISH患者降压治疗的有益。

单纯收缩期高血压病人年龄与血管内皮功能对大动脉僵硬度的影响

目的探讨单纯收缩期高血压(ISH)患者大动脉僵硬度与年龄、血管内皮功能之间的关系。方法对老年单纯收缩期高血压病人71例,进行大动脉僵硬度(主动脉脉搏波传导速度,baPWV)和内皮依赖性血管舒张功能(FMD)检测。同期年龄配对的健康老年人30例和健康中年人50例作为对照组。结果老年单纯收缩期高血压组、老年健康组、中年健康组 baPWV 依次减慢[老年 ISH:(2459.2±436.8)比老年健康:(2097.2±315.7)比中年健康:(1619.7±214.2)cm/s,P<0.01或<0.05),而 FMD 则依次增大(老年 ISH:6.2±2.2比老年健康:9.8±2.5比中年健康:14.4±1.9,P<0.05或<0.01)。在老年单纯收缩期高血压组中,baPWV 与 FMD呈显著性负相关、与收缩压(SBP)、脉压(PP)呈显著性正相关。多元逐步回归分析证明:年龄、FMD、SBP、PP 是大动脉僵硬度的危险因素。结论在老年单纯收缩期高血压病人中增龄与 FMD 失调明显增加了大动脉僵硬度,因此,在控制 ISH 的同时,改善 FMD 可以降低大动脉僵硬度,从而进一步降低心血管事件的风险。

河北省成年居民收缩期和舒张期高血压危险因素分析

目的了解河北省成年居民(18～69岁)中高血压患者危险因素状况。方法采用多阶段分层抽样的方法确定样本,统一培训调查员,采用统一的调查表进行问卷、体格和血压测量、血样检测等方法。高血压分为三类亚型,单纯收缩期高血压(ISH);单纯舒张期高血压(IDH);收缩期舒张期高血压(SDH)。结果调查的4200成年居民中有1663例高血压患者,ISH、IDH、SDH分别占26.4%、23.2%、50.5%;构成比单因素分析显示:ISH在55～64岁组(33.0%)、女性(62.2%)、小学文化(34.6%);IDH在35～44岁组(39.7%)、男性(50.1%)、初中文化(44.9%);SDH在45～54岁组(36.6%)、女性(55.4%)、初中小学文化(63.3%)占的比例最高。多因素逐步聚类分析显示:三种高血压患者危险因素有不同的聚集性。结论河北省成年居民中高血压患者以SDH为主,我们对不同的高血压患者应进行不同健康促进方式。

老年单纯收缩期高血压与颈动脉粥样硬化的关系

目的探讨老年单纯收缩期高血压患者血压与颈动脉粥硬化的关系。方法2007年5月~2008年10月在我院就诊的老年高血压患者120例,其中单纯收缩期高血压患者60例,非收缩期高血压患者60例,均予做颈动脉超声检测,比较两组颈动脉粥样硬化发生的情况。结果老年单纯收缩期高血压患者颈动脉内膜中膜增厚及粥样斑块的发生率与老年非单纯性高血压患者相比更高,差异有统计学意义（P〈0.05）,提示前者病变更加严重。结论收缩压是比舒张压更强的致动脉粥样硬化的预测因子。

两种药物联合氢氯噻嗪治疗老年单纯收缩期高血压的疗效对比研究

目的比较替米沙坦和苯磺酸左旋氨氯地平联合氢氯噻嗪治疗老年单纯收缩期高血压(ISH)的临床疗效及其安全性。方法将100例老年ISH患者随机分为2组,各50例。分别给予替米沙坦和苯磺酸左旋氨氯地平联合氢氯噻嗪治疗,观察并对比2组疗效及安全性。结果试验组总有效率显著高于对照组。2组治疗后血压、平均动脉压(MAP)均较治疗前显著降低,试验组治疗后收缩压、MAP及心率显著低于对照组,且不良反应发生率显著低于对照组。结论与苯磺酸左旋氨氯地平联合氢氯噻嗪相比,替米沙坦联合氢氯噻嗪治疗老年ISH疗效更优,且不良反应发生率更低,耐受性更高,具有显著优势,值得推广。

单纯收缩期高血压患者脉搏波传导速度与心率变异性

目的研究单纯收缩期高血压患者主动脉脉搏波传导速度与心率变异性特别是低频部分(LF)的关系,评估这两个指标与心血管危险度的相关性。方法选取单纯收缩期高血压(ISH,n=89)患者及双期高血压(DH,n=98)患者,应用 SUN-8800动脉硬化检测仪检测颈股动脉脉搏波传导速度(cfPWV)及颈桡动脉脉搏波传导速度(crPWV),采用5 min 短程频域分析法分析其心率变异性(HRV)指数。89例 ISH 根据危险程度分为低危(n=3)、中危(n=17)、高危(n=35)以及极高危(n=34)4组,观察不同危险程度组间 cfPWV、crPWV 及 HRV 指数与心血管危险程度的相关性。结果 ISH 的 cfPWV 明最高于 DH[ISH:(399.6±48.2)cm/s 比 DH:(374.3±39.7)cm/s,P<0.01],而两组 crPWV 无明显差异[ISH:(371.5±37.5)比 DH:(363.5±31.5)cm/s,P>0.05];ISH 的心率变异指数、LF 以及 LF/HF 明显高于 DH[ISH:(3.28±0.86)log ms^2比 DH:(2.93±0.59)log ms^2,P<0.05]。cfPWV 与极低频功率(VLF)、LF 呈显著正相关(P<0.05)而与 TP、HF 呈显著负相关(P<0.05),crPWV与 VLF、LF、HF 及 TP 无明显相关性。ISH 患者总体心血管风险程度与 cfPWV 及 crPWV 均呈显著正相关(r=0.765、0.563,P<0.05),cfPWV 随风险程度增高而显著增加(P<0.05),crPWV 也随风险程度增高而增加,但差异无统计学意义(P>0.05);ISH 总体心血管风险程度与 LF 呈显著正相关(r=0.479),VLF、LF、LF/HF 随风险程度增高而显著增加(P<0.01),但 TP、HF 随风险程度增加而显著降低(P<0.01)。结论提示 ISH 病人只有 cfPWV加快,而 crPWV 与正常血压相同,cfPWV 加快为指标的主动脉僵硬度与 HRV 的交感神经兴奋性指标(LF)明显相关。

普伐他汀治疗老年单纯收缩期高血压的疗效与安全性

目的:研究普伐他汀治疗老年单纯收缩期高血压(ISH)的疗效和安全性。方法:选取老年ISH患者102例,随机分为对照组和治疗组,对照组给予苯磺酸氨氯地平5mg,每日1次口服,治疗组在此基础上加用普伐他汀20mg,每晚1次口服,疗程1年。分别在用药前后监测血压、脉压(PP)、血脂、心脑血管事件发生率和不良反应。结果:治疗1年后,两组收缩压(SBP)、舒张压(DBP)及PP与治疗前比较均下降,差异有统计学意义(P<0.01),治疗组SBP及PP与对照组比较,差异有统计学意义(P<0.05),DBP差异无统计学意义(P>0.05);治疗后两组血脂指标比较,差异有统计学意义(P<0.05);两组1年内心血管病因住院率比较差异有统计学意义(P<0.05),脑血管病因住院率差异无统计学意义(P>0.05),总心、脑血管事件发生率差异有统计学意义(P<0.05);对照组出现1例轻微头痛,治疗组出现1例肝功能轻微异常,均未特殊处置。结论:普伐他汀对老年ISH患者有协同降压的作用,可缩小PP、降低血脂,减少心血管事件发生,且不良反应少,安全,可靠。

不同类型高血压人群血液流变学的比较研究

目的研究不同类型高血压人群血液流变学的变化。方法选择2015年7月在中国中医科学院广安门医院南区的体检者302名,详细记录病史,测量身高、体重、体重指数(BMI)、血压等,检测血常规、生化、血液流变学等指标,应用北京赛科希德公司生产的SA-6000全自动血流变测试仪检测体检人群的血液流变学指标,并根据血压值将其分为4组,分别为健康组(n=183)、双期高血压组(n=49)、单纯舒张期高血压组(n=30)、单纯收缩期高血压组(n=40),对4组之间的血液流变学指标进行比较研究。结果经单因素方差分析检验,血液流变水平分析:双期高血压组、单纯舒张期高血压组全血低切黏度(1/s、5/s)、全血中切黏度(50/s)、全血高切黏度(100/s、200/s)、全血低切相对指数与健康组比较,差异有统计学意义(P<0.05);同时,单纯收缩期高血压组全血低切黏度(1/s、5/s)、全血中切黏度(50/s)、全血高切黏度(100/s、200/s)分别与双期高血压组、单纯舒张期高血压组比较,差异有统计学意义(P<0.05),而与健康组比较差异无统计学意义。单纯收缩期高血压组全血高切相对指数与双期高血压组比较,差异有统计学意义(P<0.05)。而4组之间血浆黏度与红细胞聚集指数比较差异无统计学意义。血脂水平:双期高血压组、单纯舒张期高血压组、单纯收缩期高血压组三酰甘油(TG)、总胆固醇(TC)与健康组比较,差异有统计学意义(P<0.05),单纯收缩期高血压组三酰甘油、低密度脂蛋白胆固醇(LDL-C)与双期高血压组比较,差异有统计学意义(P<0.05)。偏相关性分析:TG、TC、高密度脂蛋白胆固醇(HDL-C)与全血高切相对指数呈正相关性(r=0.180,P=0.006;r=0.275,P=0.000;r=0.170,P=0.009)。结论在高血压发展过程中,单纯舒张期高血压、双期高血压均存在明显的血液黏滞状态,而单纯收缩期高血压有血液黏滞趋势,但血液黏滞状态不明显。舒张压是高血压病人全血黏度的危险因素,舒张压增高,病人的血栓形成几率增加。

辽宁省农村地区单纯收缩期高血压的患病率及危险因素调查

目的了解辽宁省农村地区单纯收缩期高血压的患病率及危险因素，为辽宁省农村地区高血压的防治提供科学依据。方法采用分层整群随机抽样方法对辽宁省阜新地区7个乡镇年龄≥35岁的30214名农村常住（≥5年）成年人进行调查。由培训过的医师对调查对象进行血压测量和资料收集。结果辽宁省农村居民单纯收缩期高血压患病率为11．92％，标化患病率为12．00％；男性患病率为11．42％，标化患病率为11．29％；女性患病率为12．42％，标化患病率为12．80％，男女间差异有显著性（P〈0．01）。不同乡镇间高血压患病率差异较大，范围为7．81％～15．04％。随着年龄的增高，单纯收缩期高血压患病率呈明显的增高趋势。多元Logistic逐步回归分析发现，年龄、性别、民族、体质指数、饮酒、食盐量等因素是单纯收缩期高血压患病的危险因素。结论辽宁省农村居民单纯收缩期高血压患病率高，且存在多种危险因素，应采取全面的预防控制措施。