Department of Cardiology, Faculty of Medicine, Baskent University, Ankara, Turkey.
J Clin Hypertens (Greenwich). 2012 Dec;14(12):871-6. doi: 10.1111/j.1751-7176.2012.00705.x. Epub 2012 Aug 27.
Isolated systolic hypertension (ISH) is a common condition in the elderly that is associated with endothelial dysfunction. Concerning the effect of type of hypertension on coronary microvascular function, coronary flow reserve (CFR) in patients with ISH was evaluated and the results were compared with patients with combined systolic/diastolic hypertension (SDH). Seventy-six elderly patients (older than 60 years) who were free of coronary artery disease and diabetes mellitus were enrolled in the study (38 with ISH and 38 with combined SDH). Using transthoracic Doppler echocardiography, CFR was calculated as the ratio of hyperemic to baseline diastolic peak flow velocities. A CFR value of >2 was accepted as normal. The mean age was 68.6±6.3 years and the groups had similar features with regard to demographic and clinical characteristics. Patients with ISH had significantly lower CFR values compared with those with combined SDH (2.22±0.51 vs 2.49±0.56, respectively; P=.03). On multivariate regression analysis, ISH (β=-0.40, P=.004) and dyslipidemia (β=-0.29, P=.04) were the independent predictors of CFR. These findings indicate that CFR, an indicator of coronary microvascular/endothelial function, is impaired more profoundly in patients with ISH than in patients with combined SDH.
孤立性收缩期高血压（ISH）是老年人常见的一种病症，与内皮功能障碍有关。关于高血压类型对冠状动脉微血管功能的影响，评估了 ISH 患者的冠状动脉血流储备（CFR），并将结果与合并收缩期/舒张期高血压（SDH）的患者进行比较。本研究纳入了 76 名无冠心病和糖尿病的老年患者（年龄均大于 60 岁）（ISH 患者 38 名，合并 SDH 患者 38 名）。使用经胸多普勒超声心动图，CFR 计算为充血期与基础舒张期峰值流速的比值。CFR 值大于 2 被认为正常。平均年龄为 68.6±6.3 岁，两组在人口统计学和临床特征方面具有相似的特征。与合并 SDH 的患者相比，ISH 患者的 CFR 值明显更低（分别为 2.22±0.51 和 2.49±0.56；P=.03）。多元回归分析显示，ISH（β=-0.40，P=.004）和血脂异常（β=-0.29，P=.04）是 CFR 的独立预测因子。这些发现表明，CFR 是冠状动脉微血管/内皮功能的一个指标，在 ISH 患者中比在合并 SDH 的患者中受损更为严重。
