摘要
目的 探讨高血压患者夜间血压对以左心室整体纵向应变(global longitudinal strain,GLS)为代表的亚临床左心室收缩功能障碍和动脉硬化的影响。方法 在一项基于社区的队列研究中,回顾性收集了199例原发性高血压(高血压)患者的GLS、动态血压监测(ABPM)数据和颈-股动脉脉搏波传导速度(pulse wave velocity,PWV)。采用多元线性回归分析和Logistic回归分析评价夜间血压与心脏、血管靶器官损害的关系。结果 199例高血压患者(平均年龄62岁)包括56.3%的女性,24.1%的吸烟者。与血压正常组患者相比,单纯性夜间高血压组患者的PWV、PWV/GLS增加,GLS降低,差异均有统计学意义(P<0.05)。与血压正常组患者比较,持续性昼夜高血压组患者的PWV、PWV/GLS升高,差异均有统计学意义(P<0.05)。多因素线性回归分析结果显示,夜间血压与GLS相关,独立于24 h血压、白天血压或诊室血压。夜间收缩压与GLS呈负相关,夜间舒张压与GLS呈正相关。校正24 h血压后,夜间血压与PWV、PWV/GLS无显著相关性。多因素Logistic回归分析结果显示,夜间收缩压与异常GLS独立相关。校正24 h收缩压后,夜间收缩压与PWV没有独立相关。结论 夜间收缩压与GLS减低独立相关,与PWV、PWV/GLS不是独立相关。对于夜间高血压患者更应该关注亚临床收缩功能障碍。
Objectives To investigate the flfects of nocturnal blood pressure(N BP)on subclinical left ventricular systolic dysfunction and arterial sifness in patients with essential hypertension.Methods In a community-based cohort study,we retrospectively collected global longitudinal strain(GLS),ambulatory blood pressure monitoring(ABPM)data and carotid-femoral pulse wave velocity(PWV)in 199 hypertensive patients.Multiple linear and Logistic regression analyses were used to assess the association between NBP with cardiac and vascular target organ damage.Results A total of 199 patients with mean age 62 years,56.3%females and 24.1%smokers had recruited.PWV and PWV/GLS were increased and GLS was decreased in isolated nocturnal hypertension group compared with normotensive group(all P<0.05).Persistent day-night hypertension had increased PWV and PW V/GLS compared with normotension(all P<0.05).In multivariate linear regression analysis,NBP associated with GLS independently of 24-hour,daytime,or office blood pressure.Nocturnal systolic blood pressure negatively correlated with GLS,and nocturnal diastolic blood pressure positively correlated with GLS.There was no significant correlation between NBP and PWV,PWVIGLS after adjusting for 24 h blood pressure.Multi-variate Logistic regression analysis showed that nocturmal systolic blood pressure independently correlated with abnormal GLS.After adjusting for 24 h systolic blood pressure,nocturmal systolic blood pressure did not independently correlate with PWV.Conclusions Nocturnal systolic blood pressure independently associates with decreasing GLS,does not independently associate with LVMI,PWV,PWVIGLS.Subclinical systolic dysfunction should be of particular concerm in patients with noctumal hypertension.
作者
周丹
吴君
ZHOU Dan;WU Jun(Office of Guangdong Cardiovascular Institute,Guangdong Provincial People′s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510080,China;Department of Cardiology,Guangdong Cardiovascular Institute,Guangdong Provincial People′s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou510080,China)
出处
《岭南心血管病杂志》
CAS
2023年第1期80-87,共8页
South China Journal of Cardiovascular Diseases
关键词
高血压
靶器官损害
左心室整体纵向应变
夜间高血压
hypertension
target organ damage
left ventricular global longitudinal strain
nocturnal hypertension
