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原发性高血压患者贫血的患病率及其相关因素

Prevalence and correlates of anaemia in essential hypertension.

作者信息

Paul Biju, Wilfred Neeta C, Woodman Richard, Depasquale Carmine

机构信息

Department of Cardiac Services and General Practice, School of Medicine, Flinders University, Adelaide, Australia.

出版信息

Clin Exp Pharmacol Physiol. 2008 Dec;35(12):1461-4. doi: 10.1111/j.1440-1681.2008.05031.x. Epub 2008 Aug 26.

Abstract
  1. Anaemia is an independent predictor of mortality in pro-atherosclerotic conditions with impaired endothelial function, such as diabetes and chronic kidney disease. However, the prevalence of anaemia in hypertension, a condition characterized by endothelial dysfunction, is unclear. 2. Haemoglobin concentration, renal function and echocardiographic parameters of 187 consecutive patients (M : F 83 : 104; mean (+/-SD) age 58 +/- 15 years) who underwent ambulatory blood pressure monitoring between 2005 and 2006 were assessed in a tertiary level university hospital. 3. The prevalence of normocytic anaemia in our cohort of hypertensive patients was 16% and was higher in patients with uncontrolled hypertension (20%) than among those with well-controlled hypertension (4%; P = 0.03). Red cell indices (mean corpuscular volume, mean cell haemoglobin and mean cell haemoglobin concentration) did not differ between the groups. However, the haemoglobin concentration was progressively lower between patients with well-controlled hypertension and uncontrolled hypertension (P = 0.007). Haematological parameters did not correlate to echocardiographic indices of left ventricular size and function. 4. Normocytic anaemia was highly prevalent in hypertensive patients. Poor blood pressure control was associated with lower haemoglobin concentration. This may indicate a higher cardiovascular risk in uncontrolled hypertension, as in other pro-atherosclerotic conditions. Additional studies are needed to evaluate the effect of anaemia on morbidity and mortality in hypertensive patients.
摘要
  1. 贫血是内皮功能受损的动脉粥样硬化性疾病(如糖尿病和慢性肾病)死亡率的独立预测因素。然而,在以内皮功能障碍为特征的高血压患者中,贫血的患病率尚不清楚。2. 2005年至2006年间,在一家三级大学医院对187例连续接受动态血压监测的患者(男:女为83:104;平均(±标准差)年龄58±15岁)的血红蛋白浓度、肾功能和超声心动图参数进行了评估。3. 在我们的高血压患者队列中,正常细胞性贫血的患病率为16%,血压控制不佳的患者(20%)高于血压控制良好的患者(4%;P = 0.03)。两组之间的红细胞指数(平均红细胞体积、平均红细胞血红蛋白和平均红细胞血红蛋白浓度)没有差异。然而,血压控制良好的患者和血压控制不佳的患者之间血红蛋白浓度逐渐降低(P = 0.007)。血液学参数与左心室大小和功能的超声心动图指标无关。4. 正常细胞性贫血在高血压患者中非常普遍。血压控制不佳与较低的血红蛋白浓度相关。这可能表明血压控制不佳的患者心血管风险较高,与其他动脉粥样硬化性疾病一样。需要进一步研究来评估贫血对高血压患者发病率和死亡率的影响。

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