原发性高血压患者静息心率与肾素血管紧张素醛固酮系统以及左心室肥厚  

Resting Heart Rate Predicted Activities Increase of Renin-Angiotensin-Aldosterone System and Its Impact on Left Ventricular Hypertrophy in Patients with Essential Hypertension

作　　者：孔瑞娜[1] 赵洛沙[1] 陈艳[1] 杨帆[1] 

机构地区：[1]郑州大学第一附属医院心内科,河南郑州450052

出　　处：《中华高血压杂志》2009年第3期243-245,共3页Chinese Journal of Hypertension

摘　　要：目的探讨原发性高血压(EH)患者静息心率(RHR)与肾素血管紧张素醛固酮系统(RAAS)变化的关系以及与左室肥厚(LVH)的关系。方法入选EH患者175例,按血压水平分为3组:140～160/90～100;160～180/100～110;≥180/110mmHg。每组按RHR水平分为RHR1组(RHR<60次/min)、RHR2组(60～70次/min)、RHR3组(70～80次/min)和RHR4组(RHR≥80次/min)。对入选患者测定RHR、血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(Ald),并进行超声心动图检查。结果RHR4组的PRA和Ald均高于RHR1和RHR2组,AngⅡ高于RHR1组(P<0.05或P<0.01)。EH伴左室肥厚组的RHR、AngⅡ以及脉压较EH不伴左室肥厚组升高(P<0.05或P<0.01)。Logistic回归分析表明RHR及脉压≥65mmHg是EH患者发生左室肥厚的危险因素。结论EH患者RHR与RAAS的变化是一致的,二者可能存在相互作用;RHR增快可能是高血压患者左室肥厚发生的危险因素。Objective To verify the hypothesis whether resting heart rate （RHR） was able to predict the activities of renin angiotensin aldosterone system （RAAS） and left ventricular hypertrophy （LVH ） in patients with hypertension. Methods One hundred and seventy-five essential hypertensive patients were categorized into three groups based on the levels of blood pressure（BP） ： 140-160/90--100; 160--180/100--110; ≥180/110 mmHg.Each group were subdivided into four groups according to the levels of RHR. RHRI： RHR〈60 beats/min; RHR2 ： RHR 60-- 70 beats/min; RHR3 ： RHR 70-- 80 beats/min ; RHR4 ： RHR≥80 beats/min. Echocardiography, plasma renin activity （PRA）, angiotensin Ⅱ（Ang Ⅱ）, aldosterone （Ald） measurement were carried out in all patients. Results RHR, Ang Ⅱ, pulse pressure were increased in hypertensive patients with LVH compared with hypertensive patients without LVH （P〈0.05 or P〈0.01 ）. Compared with RHR1 group, the RHR4 group showed significantly higher levels of PRA, Ang Ⅱ and Ald （P（0.05 or P〈0.01 ）. Logistic regressive analysis showed that RHR and pulse pressure≥65 mmHg were risk factors for LVH in essential hypertensive patients.

关 键 词：原发性高血压 静息心率 左室肥厚 肾素血管紧张素醛固酮系统 

分 类 号：R544.1[医药卫生—心血管疾病]