不同高血压亚型与代谢综合征的关系  

Relation of Hypertensive Subtype and Metabolic Syndrome

作　　者：孙瑞霞[1] 高燕燕[1] 苗志敏[2] 咸玉欣[1] 李莉[1] 李长贵[2] 

机构地区：[1]青岛大学医学院附属医院东区内科,山东青岛266003 [2]青岛大学医学院附属医院东区内分泌科,山东青岛266003

出　　处：《中华高血压杂志》2009年第2期153-156,共4页Chinese Journal of Hypertension

基　　金：青岛市科技局攻关课题(03-1-NY-14-1);国家自然科学基金资助项目(30470821)

摘　　要：背景高血压是代谢综合征(MS)的一个组分,有关高血压亚型与MS的关系尚不清楚。目的探讨不同血压分类和不同高血压亚型与MS及其组分之间的关系。方法对山东沿海地区年龄18～80岁,除外正在治疗的EH、糖尿病、血脂异常的城乡居民共4323例进行血压、人体基本参数、生化指标(空腹血糖和血脂)普查,其中男2069例,女2254例,根据美国预防、检测、评估与治疗高血压全国联合委员会第7次报告(JNC7)血压分类方法分为正常血压、高血压前期、1级高血压和2级高血压4类,原发性高血压患者又分为收缩期舒张期高血压(SDH)、单纯收缩期高血压(ISH)、单纯舒张期高血压(IDH)3个亚型,本文分析不同血压分类和高血压亚型与MS的关系。结果在4323的人群中,患MS726人,其中有高血压病的患者484例。未经降压治疗的的居民正常血压(n=1138)、高血压前期(n=1889)、1级高血压(n=781)和2级高血压(n=515)所占比例分别为26.3%、43.7%、18.1%、11.9%,它们合并MS的患病率分别为4.9%、9.9%、35.2%、40.6%。以正常血压发生MS的相对危险度为1,高血压前期发生MS的相对危险度为2.1(95%CI1.6～2.9),1级高血压为10.5(95%CI7.8～14.3),2级高血压为13.1(95%CI9.6～18.2)(P<0.01)。EH中SDH、ISH、IDH分别占54.1%、19.2%、26.7%,SDH、ISH、IDH合并MS分别占57.6%、16.9%、25.4%。SDH、ISH、IDH发生MS的相对危险度分别为12.8(95%CI10.0～17.2)、9.5(95%CI6.5～13.9),10.6(95%CI7.5～15.2)(P>0.05)。结论血压水平与腰围(WC)、体质量指数(BMI)、臀围(HC)、腰臀比(WHR)、三酰甘油(TG)、总胆固醇(TC)、空腹血糖(FPG)正相关,与高密度脂蛋白胆固醇(HDL-C)负相关;血压越高糖、脂代谢异常及MS的风险越大;女性发生MS的风险高于同等血压水平的男性;SDH是EH及MS合并EH患者的主要类型;尽管IDH的平均年龄最小,但患MS的风险并不低于SDH、ISH。Background Hypertension is one of components of metabolic syndrome （MS） , however, the relation of hypertensive subtypes and MS is not well defined. Objective To study the relation of hypertensive subtype and MS. Methods A cohort of 4323 subjects aged 18-80 years were enrolled. MS was defined by 2005 IDF. All individuals were divided into normal blood pressure（BP）, high-normal BP, 1 stage hypertension, 2 stage hypertension. Three subtypes ： systolic-diastolic hypertension （SDH）, isolated systolic hypertension（ ISH ）, isolated diastolic hypertension （IDH） were analysed seperately. Results There were 726 MS and 484 hypertensive patients in the 4323 subjects. The prevalence of normal BP, high-normal BP, 1 stage hypertension, 2 stage hypertension in this cohort of participants was： 26.3%, 43.7%, 18.1%, 11.9% respectively, the MS prevalence was 4.9% for normal BP, 9.9% for high-normal BP, 35.2% for 1 stage hypertension, 40.6% for 2 stage hypertension; After adjustment for age, sex, smoking, drinking, in relative to normotensive, partial correlation analysis revealed the RR were 2. 1（1. 6-2.9）for high-normal BP, 10.5（7.8-14.3）for 1 stage hypertension, 13.1（9.6-18.2）for 2 stage hypertension. SDH, ISH, IDH was defined 54.1%, 19.2%, 26.7% in hypertensive patients, the prevalence of SDH, ISH, IDH in MS with hypertension was 57.6%, 16.9 %, 25.4% respectively. Conclusions BP is positively correlatied with WC, BMI, HC, WHR, TG, TC, FPG, negatively correlatied with HDL-C. Prevalence of MS is increased with the increasing stage of hypertension.

关 键 词：血压分类 血压亚型 代谢综合征 

分 类 号：R544.1[医药卫生—心血管疾病] R589[医药卫生—内科学]