原发性高血压患者心率变异性及血压变异性与血管损害的相关性研究
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摘要
目的:探讨原发性高血压患者心率变异性(HRV)及血压变异性(BPV)与血管损害的相关性。方法:选取2014年12月到2017年12月期间在我院接受治疗的原发性高血压患者94例,根据脉搏波传导速度(PWV)的不同分为对照组(60例)和血管受损组(34例)。比较两组患者的HRV、BPV指标,并分析PWV与HRV、BPV指标的相关性。结果:血管受损组的5 min心搏R-R间期平均值的标准差(SDANN)低于对照组,低频(LF)、高频(HF)、低高频之比(LF/HF)高于对照组,差异均有统计学意义(P<0.05);血管受损组的24h平均收缩压(24h SBP)、24h平均脉压(24h PP)、白天平均收缩压(dSBP)、白天平均脉压(dPP)、夜间平均收缩压(nSBP)、夜间平均脉压(nPP)高于对照组,差异均有统计学意义(P<0.05);PWV与LF、HF、LF/HF、24h SBP、24h PP、dSBP、dPP、nSBP、nPP均呈正相关(P<0.05)。结论:原发性高血压患者部分HRV、BPV指标与PWV呈明显的相关性,说明HRV和BPV与患者的血管损害密切相关。
Objective: To investigate the correlation between heart rate variability(HRV) and blood pressure variability(BPV)with vascular damage in patients with essential hypertension. Methods: 94 patients with essential hypertension who were treated in our hospital from December 2014 to December 2017 were selected, and they were divided into control group(60 cases) and vascular damage group(34 cases) according to the difference of pulse wave velocity(PWV). The HRV and BPV indexes of the two groups were compared, and the correlation between PWV and HRV, BPV indexes was analyzed. Results: The standard deviation of the mean value of the 5 min heart beat R-R interval(SDANN) in the vascular damage group was lower than that of the control group, low frequency(LF),high frequency(HF) and the ratio of low frequency(LF/HF) was higher than that of the control group, and the difference was statistically significant(P<0.05). 24 h mean systolic blood pressure(24 h SBP),24 h the average pulse pressure(24 h PP), daytime average systolic blood pressure(d SBP), daytime average pulse pressure(dPP), nocturnal mean systolic blood pressure(n SBP), nocturnal average pulse pressure(nPP) in vascular damage group was higher than the control group, the differences were statistically significant(P <0.05). PWV was positively related to LF, HF, LF/HF, 24 h SBP, 24 h PP, dSBP, dPP, nSBP, nPP(P<0.05). Conclusion: The HRV and BPV indexes of patients with essential hypertension are significantly correlated with PWV, indicating that HRV and BPV are closely related to the vascular damage of the patients.
Objective: To investigate the correlation between heart rate variability(HRV) and blood pressure variability(BPV)with vascular damage in patients with essential hypertension. Methods: 94 patients with essential hypertension who were treated in our hospital from December 2014 to December 2017 were selected, and they were divided into control group(60 cases) and vascular damage group(34 cases) according to the difference of pulse wave velocity(PWV). The HRV and BPV indexes of the two groups were compared, and the correlation between PWV and HRV, BPV indexes was analyzed. Results: The standard deviation of the mean value of the 5 min heart beat R-R interval(SDANN) in the vascular damage group was lower than that of the control group, low frequency(LF),high frequency(HF) and the ratio of low frequency(LF/HF) was higher than that of the control group, and the difference was statistically significant(P<0.05). 24 h mean systolic blood pressure(24 h SBP),24 h the average pulse pressure(24 h PP), daytime average systolic blood pressure(d SBP), daytime average pulse pressure(dPP), nocturnal mean systolic blood pressure(n SBP), nocturnal average pulse pressure(nPP) in vascular damage group was higher than the control group, the differences were statistically significant(P <0.05). PWV was positively related to LF, HF, LF/HF, 24 h SBP, 24 h PP, dSBP, dPP, nSBP, nPP(P<0.05). Conclusion: The HRV and BPV indexes of patients with essential hypertension are significantly correlated with PWV, indicating that HRV and BPV are closely related to the vascular damage of the patients.
引文
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[26]Vaillancourt M,Chia P,Sarji S,et al.Autonomic nervous system involvement in pulmonary arterial hypertension[J].Respir Res,2017,18(1):201
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[2]孙磊,孟锦,赵宏伟,等.不同剂量阿伐他汀联合阿司匹林治疗原发性高血压并动脉粥样硬化的临床研究[J].现代生物医学进展,2018,18(4):681-684
[3]Lee JM,Baek JS,Choi HS,et al.Clinical Features of Benign Essential Blepharospasm in Korean Patients[J].Korean J Ophthalmol,2018,32(5):339-343
[4]Collier DJ,Juhasz A,Agabiti-Rosei E,et al.Efficacy and safety of azilsartan medoxomil/chlortalidone fixed-dose combination in hypertensive patients uncontrolled on azilsartan medoxomil alone:Arandomized trial[J].J Clin Hypertens(Greenwich),2018,20(10):1473-1484
[5]Sevencan NO,Ozkan AE.Renal resistive index and aortic knob width relationship as a predictor of renal prognosis in essential hypertension[J].Medicine(Baltimore),2018,97(40):e12434
[6]Dantas RCO,Silva JPTD,Dantas DCO,et al.Factors associated with hospital admissions due to hypertension[J].Einstein(Sao Paulo),2018,16(3):e AO4283
[7]de MirandaéJFP,Hoshi RA,Bittencourt MS,et al.Relationship between heart rate variability and subclinical thyroid disorders of the Brazilian Longitudinal Study of Adult Health(ELSA-Brasil)[J].Braz J Med Biol Res,2018,51(11):e7704
[8]VARIABLE BRAIN consortium.The association between blood pressure variability(BPV)with dementia and cognitive function:a systematic review and meta-analysis protocol[J].Syst Rev,2018,7(1):163
[9]Najafi MT,Khaloo P,Alemi H,et al.Ambulatory blood pressure monitoring and diabetes complications:Targeting morning blood pressure surge and nocturnal dipping[J].Medicine(Baltimore),2018,97(38):e12185
[10]Ostroumova OD,Borisova EV,Guseva TF,et al.Day-by Day Blood Pressure Variability:Methodological Aspects,Prognostic Value,Effects of Antihypertensive Therapy[J].Kardiologiia,2018,(8):82-88
[11]Liao R,Li J,Xiong Y,et al.Association of Peridialysis Blood Pressure and Its Variability with Cardiovascular Events in Hemodialysis Patients[J].Kidney Blood Press Res,2018,43(4):1352-1362
[12]Supiano MA,Lovato L,Ambrosius WT,et al.Pulse wave velocity and central aortic pressure in systolic blood pressure intervention trial participants[J].PLoS One,2018,13(9):e0203305
[13]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志,2011,39(7):579-616
[14]中国心血管病报告编写组.《中国心血管病报告2016》概要[J].中国循环杂志,2017,32(6):521-530
[15]Brito DJA,Dos Santos EM,Dias RSC,et al.Association between renal damage markers and carotid atherosclerosis in Afro-descendants with hypertension belonging to a minority ethnic group from Brazil[J].Ren Fail,2018,40(1):483-491
[16]Ronen JA,Nguyen A,Mueller JN,et al.Intracranial Atherosclerosis Versus Primary Angiitis of the Central Nervous System:a Case Report[J].Cureus,2018,10(7):e3031
[17]Tse G,Bazoukis G,Roever L,et al.T-Wave Indices and Atherosclerosis[J].Curr Atheroscler Rep,2018,20(11):55
[18]Javanshiri K,WaldML,Friberg N,et al.Atherosclerosis,Hypertension,and Diabetes in Alzheimer's Disease,Vascular Dementia,and Mixed Dementia:Prevalence and Presentation[J].JAlzheimers Dis,2018,65(4):1247-1258
[19]Fu X,Liu Q,Zeng X,et al.Association between Cerebral Arterial Stiffness and Large Artery Atherosclerosis in Acute Ischemic Stroke[J].J Stroke Cerebrovasc Dis,2018,27(11):2993-3000
[20]Demir S,Erten G,Artm-Esen B,et al.Increased serum leptin levels are associated with metabolic syndrome and carotid intima media thickness in premenopausal systemic lupus erythematosus patients without clinical atherosclerotic vascular events[J].Lupus,2018,27(9):1509-1516
[21]Voora R,Hinderliter AL.Modulation of Sympathetic Overactivity to Treat Resistant Hypertension[J].Curr Hypertens Rep,2018,20(11):92
[22]Ma H,Chen SR,Chen H,et al.α2δ-1 couples to NMDA receptors in the hypothalamus to sustain sympathetic vasomotor activity in hypertension[J].J Physiol,2018,596(17):4269-4283
[23]Xiong B,Li J,Yao Y,et al.Anatomy and neural remodeling of the renal sympathetic nerve in a canine model and patients with hypertension[J].J Hypertens,2018,36(10):2059-2067
[24]do Amaral Sartori S,Stein C,Coronel CC,et al.Effects of Transcutaneous Electrical Nerve Stimulation in Autonomic Nervous System of Hypertensive Patients:A Randomized Controlled Trial[J].Curr Hypertens Rev,2018,14(1):66-71
[25]Sheng Y,Zhu L.The crosstalk between autonomic nervous system and blood vessels[J].Int J Physiol Pathophysiol Pharmacol,2018,10(1):17-28
[26]Vaillancourt M,Chia P,Sarji S,et al.Autonomic nervous system involvement in pulmonary arterial hypertension[J].Respir Res,2017,18(1):201
[27]Yu S,Chi C,Protogerou AD,et al.24-hour aortic blood pressure variability showed a stronger association with carotid damage than24-hour brachial blood pressure variability:The SAFAR study[J].JClin Hypertens(Greenwich),2018,20(3):499-507
[28]Kumar A,Kalmath BC,Abraham G,et al.Role and Relevance of Blood Pressure Variability in Hypertension Related Co-morbidities[J].J Assoc Physicians India,2017,65(12):83-92
[29]Erdem Y,zkan G,Ulusoy,et al.The effect of intermittent fasting on blood pressure variability in patients with newly diagnosed hypertension or prehypertension[J].J Am Soc Hypertens,2018,12(1):42-49
[30]Li CL,Liu R,Wang JR,et al.Relationship between blood pressure variability and target organ damage in elderly patients[J].Eur Rev Med Pharmacol Sci,2017,21(23):5451-5455
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