睡眠与社区高血压患者动态血压监测指标的关联分析  

Association of sleep status with ambulatory blood pressure monitoring indicators in community-dwelling hypertensive patients

作　　者：张红梅[1] 蔡兰平[1] 王亚娟[1] 陈凌[1] 周妍妍 冷海燕[1] 阮铁梅 唐晓颖 冯雨 白雪 郑普阳 Zhang Hongmei;Cai Lanping;Wang Yajuan;Chen Ling;Zhou Yanyan;Leng Haiyan;Ruan Tiemei;Tang Xiaoying;Feng Yu;Bai Xue;Zheng Puyang(Shanghai Xinzhuang Community Health Service Centre of Minhang District,Shanghai201199,China)

机构地区：[1]上海市闵行区莘庄社区卫生服务中心,上海201199

出　　处：《中华全科医师杂志》2024年第12期1262-1269,共8页Chinese Journal of General Practitioners

基　　金：上海市闵行区公共卫生重点学科(MGWXK2023-06);上海市闵行区卫生健康委员会科研课题(2023MW24)。

摘　　要：目的:分析睡眠与社区高血压患者动态血压监测指标的关联。方法:该研究为横断面研究。纳入2021年5月至2023年4月上海市莘庄镇常住居民中进行了24 h动态血压监测的高血压患者。通过问卷获取患者的人口学资料。采用TM-2430动态血压监护仪对患者进行24 h动态血压监测,并获取相关读数。通过问卷调查患者的入睡、起床时间,并计算睡眠时长。根据睡眠时长将入选者分为<7 h组、7~8 h组和>8 h组,根据入睡时间分为早于22∶00组、22∶00~23∶00组和晚于23∶00组,根据起床时间分为早于6∶00组、6∶00~7∶00组和晚于7∶00组。分别以血压水平和血压变异系数为因变量,以性别、年龄、入睡时间、起床时间、睡眠时长等为自变量,采用多元线性回归模型分析他们之间的关联。结果:纳入患者1135例,年龄(65.07±12.61)岁,男性473例(41.67%)。入选患者中,睡眠时长<7 h者76例,7~8 h者219例,>8 h者840例;早于22∶00入睡者415例,22:00~23∶00入睡者474例,晚于23∶00入睡者246例;6∶00前起床者230例,6:00~7∶00起床者521例,7:00后起床者384例。多元线性回归分析结果显示,在控制了性别、年龄因素后,睡眠时长与日间、夜间和24 h舒张压呈负向关联(均P<0.05),与日间收缩压变异系数、夜间收缩压变异系数、夜间舒张压变异系数以及24 h收缩压变异系数呈正向关联(均P<0.05);入睡时间与日间、夜间和24 h舒张压呈正向关联(均P<0.05),与日间收缩压变异系数、日间舒张压变异系数、夜间收缩压变异系数、24 h收缩压变异系数以及24 h舒张压变异系数呈负向关联(均P<0.05);起床时间与日间收缩压以及日间、夜间和24 h舒张压呈正向关联(均P<0.05),与日间收缩压变异系数和日间舒张压变异系数呈负向关联(均P<0.05)。结论:睡眠与社区高血压患者动态血压监测指标密切相关。Objective To analyze the association between sleep status and ambulatory blood pressure monitoring indicators in community-dwelling hypertensive patients.Methods It was a cross sentional study.Hypertensive patients who underwent 24-hour ambulatory blood pressure monitoring from May 2021 to April 2023 in Shanghai Xinzhuang Town were enrolled.The demographic information and sleep status of patients were obtained from the questionnaire.A TM-2430 blood pressure monitor was used to measure 24-hour ambulatory blood pressure,and the relevant indicators,including blood pressure level and blood pressure coefficient of variation were documented.The association between sleep status and blood pressure indicators was analyzed with multivariate linear regression model.ResultsA total 1135 patients aged(65.07±12.61)years were enrolled,and 473(41.67%)of whom were males.The sleep time was<7 hours in 76 cases,7-8 hours in 219 cases and>8 hours in 840 cases;the bedtime was earlier than 22∶00 in 415 cases,between 22∶00 and 23∶00 in 474 cases and later than 23∶00 in 246 cases;the wake-up time was before 6∶00 in 230 cases,between 6∶00 and 7∶00 in 521 cases and after 7∶00 in 384 cases.Multivariate linear regression analysis showed that after controlling for gender and age,the sleep time was negatively associated with diurnal,noctumal and 24-hour diastolic blood pressure levels(all P<0.05),and positively associated with diurnal and noctumal systolic blood pressure coefficient of variation,noctumal diastolic blood pressure coefficient of variation,and 24-hour systolic blood pressure coefficient of variation(all P<0.05).The bedtime was positively associated with diurnal,noctumal and 24-hour diastolic blood pressure(all P<0.05),diastolic blood pressure(all P<0.05);and negatively associated with diurnal systolic blood pressure coefficient of variation,diurnal diastolic blood pressure coefficient of variation,noctumal systolic blood pressure coefficient of variation,24-hour systolic blood pressure coefficient of variation,and

关 键 词：高血压 睡眠 血压变异性 

分 类 号：R544.1[医药卫生—心血管疾病]