高血压合并冠心病患者晨峰血压变化与心脑血管事件发生的相关性

Juhua Zhang, Yigong Wang
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摘要

目的分析高血压合并冠心病(CHD)患者晨峰血压变化与心脑血管事件发生的相关性。方法选取2015年3月至2018年3月驻马店市中心医院收治的高血压合并冠心病患者90例为研究对象。采用动态血压监测仪检测并记录24 h血压。将晨起血压峰值大于等于35 mmHg (1 mmHg=0.133 kPa)的患者分为早峰组(n=40),晨起血压峰值小于35 mmHg的患者分为非早峰组(n=50)。比较两组一般资料、血压参数、心脑血管事件发生率。所有患者随访1年。分析晨高峰血压变化与心脑血管事件发生的相关性。结果晨峰组患者晨峰值、平均晨动脉压(MAP)、24 h收缩压均高于非晨峰组(P < 0.05)。随访1年,晨峰组急性冠脉综合征、心律失常、缺血性脑血管病和出血性脑血管病的发病率分别为25.00%(10/40)、22.50%(9/40)、20.00%(8/40)和20.00%(8/40),高于非晨峰组的8.00%(4/50)、6.00%(3/50)、4.00%(2/50)和4.00%(2/50)(P < 0.05)。结论高血压合并冠心病患者清晨血压峰值与心脑血管事件的发生密切相关。因此,对于高血压合并冠心病患者,临床应监测和控制清晨血压峰值。关键词:高血压;冠心病;早晨血压峰值;心脑血管事件;相关
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Correlation between changes in peak morning blood pressure and occurrence of cardiovascular and cerebrovascular events in patients with hypertension complicated by coronary heart disease
Objective To analyze the correlation between changes in peak morning blood pressure and occurrence of cardiovascular and cerebrovascular events in patients with hypertension complicated by coronary heart disease (CHD). Methods Ninety patients with hypertension complicanted by CHD who were admitted to Zhumadian Central Hospital from March 2015 to March 2018 were selected as research objects. The 24 h blood pressure was detected and recorded by dynamic blood pressure monitor. Patients with peak morning blood pressure greater than or equal to 35 mmHg (1 mmHg=0.133 kPa) were included in morning peak group (n=40), and patients with peak morning blood pressure lower than 35 mmHg were included in non-morning peak group (n=50). The general data, blood pressure parameters, incidences of cardiovascular and cerebrovascular events were compared between the two groups. All patients were followed up for one year. And the correlation between changes in peak morning blood pressure and occurrence of cardiovascular and cerebrovascular events was analyzed. Results The peak morning value, mean morning arterial pressure (MAP) and 24 h systolic blood pressure in morning peak group were higher than those in non-morning peak group (all P 0.05). During one-year follow-up, the morbidity rates of acute coronary syndrome, arrhythmia, ischemic cerebrovascular disease and hemorrhagic cerebrovascular disease in morning peak group were 25.00% (10/40), 22.50% (9/40), 20.00% (8/40) and 20.00% (8/40), respectively, higher than the 8.00%(4/50), 6.00%(3/50), 4.00%(2/50)amd 4.00%(2/50) in non-morning peak group (P 0.05). Conclusions The peak morning blood pressure in patients with hypertension complicated by CHD is closely related to occurrence of cardiovascular and cerebrovascular events. Therefore, for patients with hypertension complicated by CHD, peak morning blood pressure value should be monitored and controlled in clinical. Key words: Hypertension; Coronary heart disease; Peak morning blood pressure; Cardiovascular and cerebrovascular event; Correlation
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