Hoshida Shiro, Shinoda Yukinori, Inui Hirooki, Hosoi Ryoji, Teranishi Fumiko, Asaoka Nobuaki, Sugitani Toshifumi, Hamasaki Toshimitsu
Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Osaka.
J Clin Hypertens (Greenwich). 2014 Aug;16(8):606-11. doi: 10.1111/jch.12368. Epub 2014 Jul 14.
This study aimed to define the difference in cardiac hypertrophy between hypertensive patients with and without renal artery stenosis (RAS). When cardiac ultrasonographic examination was performed in 971 consecutive hypertensive outpatients, renal peak systolic velocity (PSV) was examined. Compared with patients without RAS, those with RAS (PSV ≥180 cm/s, 4.1%) were significantly older and included a higher proportion of male patients and had a higher left ventricular mass index (LVMI). A stratified analysis in the selected 120 patients showed that the LVMI was significantly higher in patients with RAS than in those without RAS for each confounding factor such as age and blood pressure. RAS was independently associated with a higher LVMI on propensity score analysis and multivariate analysis. Thus, the difference in LVMI between hypertensive patients with and without RAS was confirmed, irrespective of age and blood pressure, by stratified propensity score analysis and multivariate regression analysis.
本研究旨在明确有和没有肾动脉狭窄(RAS)的高血压患者之间心脏肥大的差异。对971例连续就诊的高血压门诊患者进行心脏超声检查时,检测了肾动脉收缩期峰值流速(PSV)。与没有RAS的患者相比,有RAS的患者(PSV≥180 cm/s,占4.1%)年龄显著更大,男性患者比例更高,左心室质量指数(LVMI)也更高。对选定的120例患者进行的分层分析显示,对于年龄和血压等每个混杂因素,有RAS的患者LVMI显著高于没有RAS的患者。倾向评分分析和多变量分析表明,RAS与较高的LVMI独立相关。因此,通过分层倾向评分分析和多变量回归分析证实,无论年龄和血压如何,有和没有RAS的高血压患者之间LVMI存在差异。