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动态血压个体间差异的预测因素及其时间或活动依赖性。

Predictors of interindividual variation in ambulatory blood pressure and their time or activity dependence.

作者信息

Schwartz G L, Turner S T, Moore J H, Sing C F

机构信息

Division of Hypertension, Mayo Clinic, Rochester, Minnesota 55905, USA.

出版信息

Am J Hypertens. 2000 Jan;13(1 Pt 1):52-60. doi: 10.1016/s0895-7061(99)00127-2.

Abstract

The objectives of this study were to determine whether total interindividual variation in blood pressure (BP) differs between inactive and active hours of the day, to identify predictors of interindividual variation in BP, and to assess whether variation associated with any of these identified predictors is greater (or less) during inactive hours than during active hours of the day. We obtained ambulatory BP recordings over 20 consecutive hours (12 active, out of bed [daytime]; and 8 inactive, in bed [nighttime]) in a sample of 240 unrelated, non-Hispanic white adults (138 men; 102 women). We estimated total interindividual variation in BP, and the percentage of interindividual variation associated with measures of age and body size, metabolic traits, catecholamines, erythrocyte cation transport, and renal function. We used linear regression to assess changes in the hourly estimates of total interindividual variation and in variation attributable to each set of predictor traits over the 20 h. In both men and women, total interindividual variation in systolic BP was significantly greater (not less) during inactive hours than during active hours. In addition, in women, total interindividual variation in diastolic BP was as great during inactive hours as during active hours. Each set of traits considered predicted a statistically significant percentage of interindividual variation in BP. None of the sets of traits predicted a greater percentage of interindividual variation during the inactive hours than during the active hours. Measures of age and body size, catecholamines, cation transport and renal function traits predicted significantly less interindividual variation during inactive hours than during active hours of the day. That total interindividual variation in BP is as great or greater during inactive hours than during active hours of the day emphasizes the potential for differences in nighttime BP to contribute to the development of cardiovascular disease. In as much as the predictors of interindividual variation in BP differ between the daytime and nighttime, the causes of variation during these two times may also differ.

摘要

本研究的目的是确定一天中不活动时间和活动时间的血压(BP)个体间总变异是否存在差异,识别血压个体间变异的预测因素,并评估与这些已识别预测因素相关的变异在不活动时间是否比活动时间更大(或更小)。我们在240名无亲属关系、非西班牙裔白人成年人(138名男性;102名女性)的样本中,连续20小时(12小时活动,起床[白天];8小时不活动,卧床[夜间])获取动态血压记录。我们估计了血压的个体间总变异,以及与年龄、体型、代谢特征、儿茶酚胺、红细胞阳离子转运和肾功能测量相关的个体间变异百分比。我们使用线性回归来评估在这20小时内个体间总变异的每小时估计值以及每组预测特征所致变异的变化。在男性和女性中,收缩压的个体间总变异在不活动时间显著大于(而非小于)活动时间。此外,在女性中,舒张压的个体间总变异在不活动时间与活动时间一样大。所考虑的每组特征都预测了血压个体间变异的一个具有统计学意义的百分比。没有一组特征预测在不活动时间的个体间变异百分比大于活动时间。年龄、体型、儿茶酚胺、阳离子转运和肾功能特征的测量值在不活动时间预测的个体间变异显著小于活动时间。血压个体间总变异在不活动时间与活动时间一样大或更大,这强调了夜间血压差异对心血管疾病发展的潜在影响。由于血压个体间变异的预测因素在白天和夜间有所不同,这两个时间段变异的原因可能也不同。

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