[孤立性夜间高血压与左心室肥厚之间的关系]

[The relationship between isolated nocturnal hypertension and left ventricular hypertrophy].

作者信息

Lu Lu, Li Yan, Huang Qi-Fang

机构信息

Centre for Epidemiological Studies and Clinical Trials, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2008 Oct;47(10):819-22.

PMID:19080140

Abstract

OBJECTIVE

To investigate the relationship between isolated nocturnal hypertension and left ventricular hypertrophy.

METHODS

In the inhabitants of 14 villages in Jingning County, Zhejiang Province, we performed 24-hour ambulatory blood pressure monitoring with SpaceLab monitors and measured 12-lead resting electrocardiogram using an electronic recording system of GE company. Left ventricular hypertrophy was diagnosed with the criteria of Sokolow-Lyon voltage amplitude and Cornell product. Isolated nocturnal hypertension was defined as a nighttime (from 22:00 to 4:00) blood pressure of > or = 120/70 mm Hg (1 mm Hg = 0.133 kPa). Isolated daytime (from 8:00 to 18:00) hypertension was a diurnal blood pressure of > or = 135/85 mm Hg. When both conditions were present or absent, subjects were classified either as having combined day-night hypertension or as normotensive on ambulatory measurement. Analysis of variance and multiple regressions were used for statistical analysis.

RESULTS

647 participants (53.9% being female, average age 47.8 years) included 72 patients with isolated nocturnal hypertension, 33 with isolated daytime hypertension and 248 with day-night sustained hypertension. Compared with normotensive subjects, patients with isolated nocturnal hypertension and day-night sustained hypertension had a higher Sokolow-Lyon voltage amplitude and Cornell product. However, after adjustment for sex, age, body mass index, drinking and smoking habits, serum total cholesterol, fasting blood glucose and the use of antihypertensive drugs, only day-night hypertensive patients had a significantly higher Sokolow-Lyon voltage (32.8 mV, P = 0.0003) and Cornell product (1371 mV x ms, P = 0.0004) than normotensive subjects (29.0 mV, 1114 mV x ms). Regardless of whether Sokolow-Lyon or Cornell criteria were used, both nighttime and daytime systolic and diastolic blood pressure were independent risk factors of left ventricular hypertrophy (P < 0.01). However, the prevalence of left ventricular hypertrophy in patients with isolated nocturnal hypertension (23.6%) study was not statistically different from that in normotensives (17.4%, P = 0.24).

CONCLUSION

In our current cross-sectional study, isolated nocturnal hypertension was not independently related to left ventricular hypertrophy diagnosed with ECG criteria.

摘要

目的

探讨单纯夜间高血压与左心室肥厚之间的关系。

方法

在浙江省景宁县14个村庄的居民中，我们使用太空实验室监测仪进行24小时动态血压监测，并使用通用电气公司的电子记录系统测量12导联静息心电图。根据索科洛 - 里昂电压幅度标准和康奈尔乘积标准诊断左心室肥厚。单纯夜间高血压定义为夜间（22:00至4:00）血压≥120/70 mmHg（1 mmHg = 0.133 kPa）。单纯日间（8:00至18:00）高血压定义为日间血压≥135/85 mmHg。当两种情况都存在或都不存在时，受试者在动态测量中被分类为合并昼夜高血压或血压正常。采用方差分析和多元回归进行统计分析。

结果

647名参与者（53.9%为女性，平均年龄47.8岁），其中包括72例单纯夜间高血压患者、33例单纯日间高血压患者和248例昼夜持续性高血压患者。与血压正常的受试者相比，单纯夜间高血压患者和昼夜持续性高血压患者的索科洛 - 里昂电压幅度和康奈尔乘积更高。然而，在调整性别、年龄、体重指数、饮酒和吸烟习惯、血清总胆固醇、空腹血糖以及使用抗高血压药物后，只有昼夜高血压患者的索科洛 - 里昂电压（32.8 mV，P = 0.0003）和康奈尔乘积（1371 mV×ms，P = 0.0004）显著高于血压正常的受试者（29.0 mV，1114 mV×ms）。无论使用索科洛 - 里昂标准还是康奈尔标准，夜间和日间的收缩压和舒张压都是左心室肥厚的独立危险因素（P < 0.01）。然而，单纯夜间高血压患者左心室肥厚的患病率（23.6%）与血压正常者（17.4%，P = 0.24）相比，差异无统计学意义。