Erdogan Dogan, Gullu Hakan, Caliskan Mustafa, Yildirim Ibrahim, Ulus Taner, Bilgi Muhammet, Muderrisoglu Haldun
Cardiology Department, Konya Teaching and Medical Research Center, Baskent University, Konya, Turkey.
Blood Press. 2005;14(6):345-52. doi: 10.1080/08037050500356550.
Failure to decrease blood pressure (BP) normally during night-time, which is called non-dipping, in hypertensive individuals is associated with higher cardiovascular morbidity and mortality. In addition, non-dipping BP leads to structural changes in the left ventricle; however, the effect of non-dipping BP on coronary flow reserve (CFR) has not been studied yet.
In this study, we measured CFR of 22 subjects with non-dipper hypertension, and 15 subjects with dipper hypertension using transthoracic second-harmonic Doppler echocardiography (Acuson Sequoia C256. None of the subjects had any systemic disease or coronary risk factor except hypertension.
Age, gender, body mass index, lipids and echocardiographic findings including left ventricular mass index were similar between the groups. Office BP recordings were similar between non-dipper and dipper groups (147.9+/-6.1/93.9+/-4.3 vs 144.0+/-8.0/93.0+/-3.7). Daytime and 24-h ambulatory BP measurements were similar within the groups, but night-time BPs were significantly greater in non-dipper group than those were in dipper group. Left ventricular diastolic and systolic functions, and both baseline and hyperemic peak diastolic coronary velocity as well as CFR, were similar between the non-dipper and dipper groups (CFR: 2.47+/-0.59 vs 2.39+/-0.47).
CFR were similar in patients with non-dipper and dipper hypertension in the absence of excessive left ventricular hypertrophy and other cardiovascular risk factors.
高血压患者夜间血压未能正常下降，即所谓的非勺型血压，与较高的心血管发病率和死亡率相关。此外，非勺型血压会导致左心室结构改变；然而，非勺型血压对冠状动脉血流储备（CFR）的影响尚未得到研究。
在本研究中，我们使用经胸二次谐波多普勒超声心动图（Acuson Sequoia C256）测量了22例非勺型高血压患者和15例勺型高血压患者的CFR。除高血压外，所有受试者均无任何全身性疾病或冠状动脉危险因素。
两组之间的年龄、性别、体重指数、血脂以及包括左心室质量指数在内的超声心动图检查结果相似。非勺型组和勺型组的诊室血压记录相似（147.9±6.1/93.9±4.3与144.0±8.0/93.0±3.7）。两组内日间和24小时动态血压测量结果相似，但非勺型组的夜间血压显著高于勺型组。非勺型组和勺型组之间的左心室舒张和收缩功能、基线和充血时舒张期冠状动脉峰值速度以及CFR相似（CFR：2.47±0.59对2.39±0.47）。
在无过度左心室肥厚和其他心血管危险因素的情况下，非勺型和勺型高血压患者的CFR相似。
