Enström I, Burtscher I M, Eskilsson J, Holm K, Holtås S, Pennert K, Thulin T
Kävlinge Health Centre, Sweden.
Blood Press. 2000;9(1):28-33.
High blood pressure contributes to organ damage. However, during the past two decades there have been great advances in the medical treatment of hypertension. Technical progress has also made it easier to visualize organ damage. Hence we found it of interest to examine heart, brain and retina in a group of middle-aged treated hypertensives, comparing the results with those from a group of middle-aged normotensives.
The subjects were 40 (20 men) treated hypertensives and 40 (20 men) normotensives, who had previously taken part in a study in which ambulatory blood pressure monitoring had been performed. The heart was examined by echocardiography, the retina by photography and the brain by magnetic resonance imaging.
Office blood pressure and 24-h systolic/diastolic blood pressure (S/D) were 141/86 (13/7) mmHg and 128/81 (11/6) mmHg in the hypertensives and 125/78 (10/8) mmHg and 118/74 (8/5) mmHg in the normotensives, respectively. Left ventricular mass was 101 (27) g/m2 in the hypertensives and 85 (18) g/m2 in the normotensives (p = 0.0025). The corresponding figures for the left atrium were 21.1 (3.1) mm/m2 in the hypertensives and 19.5 (2.2) mm/m2 in the normotensives (p < 0.001). E/A wave quotient was 1.09 (0.26) in the hypertensives and 1.26 (0.26) in the normotensives (p = 0.0045), while left ventricular systolic function did not differ between the groups. Ten hypertensives and one normotensive subject had left ventricular mass above normal range. Narrow retinal arteries were found in 22 hypertensives and 8 normotensives (p < 0.001). Brain magnetic resonance changes (deep white matter and/or periventricular) were found in 19 hypertensives and 9 normotensives (p = 0.0431).
The hypertensives differed significantly from the normotensives concerning left ventricular mass, left atrium, left ventricular diastolic function and retinal vessel changes. Deep white matter and periventricular changes in the brain were also significantly different in the two groups. We can only speculate as to whether earlier antihypertensive treatment or further blood pressure reduction could have affected these differences.
高血压会导致器官损害。然而，在过去二十年中，高血压的医学治疗取得了巨大进展。技术进步也使观察器官损害变得更加容易。因此，我们发现研究一组中年接受治疗的高血压患者的心脏、大脑和视网膜，并将结果与一组中年血压正常者的结果进行比较很有意义。
受试者为40名（20名男性）接受治疗的高血压患者和40名（20名男性）血压正常者，他们之前参与过一项进行了动态血压监测的研究。通过超声心动图检查心脏，通过摄影检查视网膜，通过磁共振成像检查大脑。
高血压患者的诊室血压和24小时收缩压/舒张压（S/D）分别为141/86（13/7）mmHg和128/81（11/6）mmHg，血压正常者分别为125/78（10/8）mmHg和118/74（8/5）mmHg。高血压患者的左心室质量为101（27）g/m²，血压正常者为85（18）g/m²（p = 0.0025）。左心房的相应数值在高血压患者中为21.1（3.1）mm/m²，在血压正常者中为19.5（2.2）mm/m²（p < 0.001）。高血压患者的E/A波商为1.09（0.26），血压正常者为1.26（0.26）（p = 0.0045），而两组之间的左心室收缩功能没有差异。10名高血压患者和1名血压正常者的左心室质量高于正常范围。22名高血压患者和8名血压正常者发现视网膜动脉变窄（p < 0.001）。19名高血压患者和9名血压正常者发现脑磁共振改变（深部白质和/或脑室周围）（p = 0.0431）。
高血压患者在左心室质量、左心房、左心室舒张功能和视网膜血管变化方面与血压正常者有显著差异。两组大脑深部白质和脑室周围的变化也有显著差异。对于早期抗高血压治疗或进一步降低血压是否会影响这些差异，我们只能进行推测。
