血压正常高值者血压晨峰与冷加压试验的相关性  

Association between morning blood pressure surge and cold pressure test in prehypertensive patients

作　　者：刘振东[1,2] 董元丽 路方红[2] 赵颖馨[2] 孙尚文[2] 王舒健[2] 王琳[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院心内科,湖北武汉430030 [2]山东省医学科学院基础医学研究所心脑血管病防治研究中心,山东济南250062 [3]山东省临沂市兰山区第一人民医院内科,山东临沂256002

出　　处：《心脏杂志》2012年第2期193-196,共4页Chinese Heart Journal

基　　金：山东省自然科学基金项目资助(ZR2009CL029);山东省医药卫生计划项目资助(2009HW080);山东省医学科学院项目资助(2009-16;2009-17)

摘　　要：目的:探讨血压正常高值者血压晨峰现象与冷加压试验后血压变化的相关性。方法:将258例受试者按血压水平分为理想血压组、血压正常高值组和高血压病组。所有受试者均进行24小时动态血压监测及冷加压试验。结果:血压正常高值者清晨血压上长幅度为(27±9)mmHg,冷加压后0 s及60 s SBP增加幅度分别为(14±6)mmHg及(9±5)mmHg,晨峰及冷加压试验阳性发生率分别为45%及26%,低于高血压病组,但明显高于理想血压组(P<0.05)。血压晨峰、吸烟史、年龄及高密度脂蛋白胆固醇是影响0 s SBP增加幅度的主要因素;血压晨峰、年龄及空腹血糖是影响60 s SBP增加幅度的主要因素。结论:血压正常高值者清晨血压上升明显,冷加压后血压显著上升,冷加压后血压增幅与血压晨峰相关。AIM： To explore the association between morning blood pressure surge and changes of blood pressure after cold pressure test in prehypertensive patients. METHODS： According to blood pressure levels, 258 subjects were divided into three groups, namely, normotensive group, prehypertensive group and hypertensive group. Twenty-four hour ambulatory blood pressure monitoring and cold pressure test were conducted in all subjects. RESULTS： Morning blood pressure surge was （27 ＋-9 ） mmHg and the increased amplitude of systolic blood pressure at 0 and 60 see after cold pressure test was （ 14 ＋- 6） mmHg and （9 ＋- 5 ） mmHg, respectively. The rate of positive morning blood pressure surge and cold pressure test was 45% and 26% in prehypertensive group, lower than that in the hypertensive group but signifi- cantly higher than that in the normotensive group （ P 〈 0.05 ）. Morning blood pressure surge, smoking history, age and high-density lipoprotein were important factors for the increased amplitude of systolic blood pressure at 0 sec after cold pressure test. Morning blood pressure surge, age and fasting plasma glucose were important factors for the increased amplitude of systolic blood pressure at 60 sec after cold pressure test. CONCLUSION： Sympathetic nervous system activity was enhanced in prehypertensive patients. Blood pressure was significantly elevated in the morning and after cold pressure test in prehyper- tensive patients. Increased amplitude of blood pressure after cold pressure test is associated with morning blood pressure surge in prehypertensive patients.

关 键 词：血压正常高值 交感神经活性 血压晨峰 冷加压试验 

分 类 号：R544.1[医药卫生—心血管疾病]