Ghanbarian Arash, Rashidi Arash, Madjid Mohammad, Azizi Fereidoun
Endocrine and Metabolism Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
J Clin Hypertens (Greenwich). 2004 Feb;6(2):71-5. doi: 10.1111/j.1524-6175.2004.02984.x.
The purpose of this study was to describe blood pressure values in Iranian adults with electrocardiogram (ECG) evidence of a myocardial infarction (MI). High blood pressure is a risk factor, and an ECG can be diagnostic of coronary artery disease. In recent studies the role of pulse pressure in predicting coronary artery disease has been suggested to be more important than that of blood pressure. From among participants of the Tehran Lipid and Glucose study, data for 2479 men and 3060 women aged > or =30 years not currently using any antihypertensive medication were collected. The study used the mean of two separate blood pressure measurements for each individual. ECG findings of all subjects were coded according to Minnesota ECG coding criteria, and they were categorized into probable/possible MI or no MI. ECG evidence of probable or possible MI was found in 1.2% of subjects (1.8% in men vs. 0.8% in women, p<0.001). Prevalence of ECG-defined MI in hypertensive persons was two-fold higher than in normotensives. Adjusted for age, sex, and body mass index, mean diastolic blood pressure was significantly lower in cases with ECG-defined MI than in subjects without MI (p<0.03). There was a strong positive correlation between pulse pressure and systolic blood pressure in both hypertensive/normotensive and MI/no MI groups at the p<0.001 level. There was a weak inverse correlation between diastolic blood pressure and pulse pressure in hypertensive/normotensive/no MI groups (-0.32 and -0.14, both p<0.001). Diastolic blood pressure was not correlated with pulse pressure in cases with MI. Prevalence of ECG-defined MI in hypertensive cases was higher than in normotensives. Systolic blood pressure is a better predictor for pulse pressure than diastolic blood pressure in both normotensive and hypertensive populations with or without ECG-defined MI.
本研究的目的是描述有心肌梗死（MI）心电图（ECG）证据的伊朗成年人的血压值。高血压是一个风险因素，而心电图可用于诊断冠状动脉疾病。最近的研究表明，脉压在预测冠状动脉疾病方面的作用可能比血压更为重要。从德黑兰血脂与血糖研究的参与者中，收集了2479名年龄≥30岁且目前未使用任何抗高血压药物的男性和3060名女性的数据。该研究采用了对每个个体进行两次独立血压测量的平均值。所有受试者的心电图结果根据明尼苏达心电图编码标准进行编码，并分为可能/疑似心肌梗死或无心肌梗死。在1.2%的受试者中发现了可能或疑似心肌梗死的心电图证据（男性为1.8%，女性为0.8%，p<0.001）。心电图定义的心肌梗死在高血压患者中的患病率是血压正常者的两倍。在调整年龄、性别和体重指数后，心电图定义的心肌梗死患者的平均舒张压显著低于无心肌梗死的受试者（p<0.03）。在高血压/血压正常组和心肌梗死/无心肌梗死组中，脉压与收缩压之间在p<0.001水平上均存在强正相关。在高血压/血压正常/无心肌梗死组中，舒张压与脉压之间存在弱负相关（分别为-0.32和-0.14，p均<0.001）。心肌梗死患者的舒张压与脉压无相关性。心电图定义的心肌梗死在高血压患者中的患病率高于血压正常者。在有或无心电图定义的心肌梗死的血压正常和高血压人群中，收缩压比舒张压更能预测脉压。
