Cemri Mustafa, Ceyhan Mert, Hodoğlugil Uğur, Durakoğlugil Deniz Barlas, Dörtlemez Halis, Zengil Hakan
Department of Cardiology, Faculty of Medicine, Gazi University, Ankara Turkey.
Anadolu Kardiyol Derg. 2006 Dec;6(4):322-6.
The aim of this study was to to determine possible daytime (awake hours) and nighttime (sleeping hours) LOAD limits for ambulatory pulse pressure (PP) and double product (DP) in hypertensive (HT) subjects and secondly to assess whether there were significant differences in the LOAD values between hypertensive (HT) and normotensive (NT) subjects.
Seventy-eight untreated essential HT (46 female, 32 male; mean age 51.9+/-1.4 years) and 115 NT (89 female, 26 male; mean age 40.8+/-1.1 years) subjects participated in this study. Ambulatory blood pressure monitoring (ABPM) devices were applied to these subjects for 48 hours. Different possible ambulatory PP LOAD limits between 40 and 55 mmHg with 5 mmHg increments and ambulatory DP LOAD limits between 6000 and 12,000 mmHg x beats/min with 1000 mmHg x beats/min increments were used. Then according to these limits, LOAD values of NT and HT subjects have been assessed for daytime, nighttime and 48 hours.
There were significant differences between NT and HT subjects in all the values for both ambulatory PP and DP. Although mean (total, day and night mean) values of HT subjects were higher approximately by 20% than of NT subjects, LOAD values for ambulatory PP in HTs were 33%-415% higher than in NTs (p<0.001). Hypertensive subjects' mean (total, day and night mean) values of DP were by 23%-33% higher than NTs values, but LOAD values for ambulatory DP in hypertensives were approximately 43%-673% higher than in NT subjects (p<0.001).
We showed that although there were significant differences in the 48-hour, daytime and nighttime PP and DP means between NT and HT subjects, these differences became more prominent when possible LOAD limits were used for ambulatory PP and DP, One of these possible ambulatory PP and DP LOAD limits can be used in the clinical settings if a relationship with the end-organ damage will be showed by further studies.
本研究旨在确定高血压（HT）患者日间（清醒时间）和夜间（睡眠时间）动态脉压（PP）及双乘积（DP）的可能负荷限值，其次评估高血压（HT）患者和血压正常（NT）患者的负荷值是否存在显著差异。
78例未经治疗的原发性高血压患者（46例女性，32例男性；平均年龄51.9±1.4岁）和115例血压正常者（89例女性，26例男性；平均年龄40.8±1.1岁）参与了本研究。对这些受试者应用动态血压监测（ABPM）设备48小时。使用了40至55 mmHg之间不同的可能动态PP负荷限值，增量为5 mmHg，以及6000至12,000 mmHg·次/分钟之间不同的可能动态DP负荷限值，增量为1000 mmHg·次/分钟。然后根据这些限值，评估了NT和HT受试者日间、夜间及48小时的负荷值。
NT和HT受试者在动态PP和DP的所有值上均存在显著差异。虽然HT受试者的平均（总计、日间和夜间平均）值比NT受试者高约20%，但HT患者动态PP的负荷值比NT患者高33% - 415%（p<0.001）。高血压受试者DP的平均（总计、日间和夜间平均）值比NT受试者高23% - 33%，但高血压患者动态DP的负荷值比NT受试者高约43% - 673%（p<0.001）。
我们表明，虽然NT和HT受试者在48小时、日间和夜间的PP和DP均值存在显著差异，但当使用动态PP和DP的可能负荷限值时，这些差异变得更加突出。如果进一步研究表明与终末器官损害存在关联，这些可能的动态PP和DP负荷限值之一可用于临床。
