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在未经治疗的甲状腺功能正常的高血压男性中,促甲状腺激素处于正常高值与动脉僵硬度、中心收缩压及24小时收缩压相关。

A high normal thyroid-stimulating hormone is associated with arterial stiffness, central systolic blood pressure, and 24-hour systolic blood pressure in males with treatment-naïve hypertension and euthyroid.

作者信息

Kwon Beom-June, Roh Ji-Woong, Lee Su-Hyun, Lim Sung-Min, Park Chan-Seok, Kim Dong-Bin, Jang Sung-Won, Chang Kiyuk, Kim Hee-Yeol, Ihm Sang-Hyun

机构信息

Department of Cardiology, Seogwipo Medical Center, Jeju, Republic of Korea.

Department of Cardiology, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Int J Cardiol. 2014 Dec 20;177(3):949-56. doi: 10.1016/j.ijcard.2014.09.200. Epub 2014 Oct 7.

Abstract

BACKGROUND

We compared the results of laboratory examinations, echocardiography, arterial stiffness, central blood pressure (BP) and ambulatory BP monitoring (ABPM) between treatment-naïve patients with low normal thyroid-stimulating hormone (TSH) and those with high normal TSH levels.

METHODS

A total of 285 consecutively-eligible patients with both treatment-naïve hypertension and euthyroid were divided into two groups: those with low-normal TSH (0.40-1.99 μIU/mL, group 1) and high-normal TSH (2.00-4.50 μIU/mL, group 2) and compared according to group and gender.

RESULTS

Males were divided into group 1 (n = 113, 68.9%) and group 2 (n = 51, 31.1%) and females were divided into group 1 (n = 71, 58.7%) and group 2 (n = 50, 41.3%). Multivariate analyses revealed that the augmentation index (71.0 [adjusted mean] ± 1.7 [standard error] vs. 78.8 ± 2.5%, P = 0.045), central systolic BP (SBP) (143.3 ± 2.1 vs. 153.0 ± 3.2 mmHg, P = 0.013), systemic vascular resistance (SVR, 21.4 ± 0.6 vs. 23.9 ± 0.9 mmHg/L/min, P = 0.027), SBP during daytime (144.1 ± 1.4 vs. 151.6 ± 2.1 mmHg, P=0.004) and nighttime (130.4 ± 1.6 vs. 138.5 ± 2.5 mmHg, P=0.008), and nighttime pulse pressure (PP, 47.2 ± 0.9 vs. 51.7 ± 1.4 mmHg, P = 0.010) were significantly higher while cardiac output (5.4 ± 0.1 vs. 4.8 ± 0.2L/min, P = 0.043) and PP amplification (1.02 ± 0.02 vs. 0.94 ± 0.03, P = 0.039) were significantly lower in the male group 2 than in the male group 1. However, there were no significant differences between the two groups in females.

CONCLUSIONS

Treatment-naïve hypertensive males with high normal TSH and euthyroid showed higher arterial stiffness, central SBP, SVR, and SBP in ABPM and lower cardiac output and PP amplification as compared to the the low normal TSH group, but not females.

摘要

背景

我们比较了初次接受治疗的促甲状腺激素(TSH)水平略低于正常范围和略高于正常范围的患者之间的实验室检查结果、超声心动图、动脉僵硬度、中心血压(BP)及动态血压监测(ABPM)情况。

方法

总共285例初次接受治疗的高血压且甲状腺功能正常的连续入选患者被分为两组:TSH略低于正常范围(0.40 - 1.99 μIU/mL,第1组)和TSH略高于正常范围(2.00 - 4.50 μIU/mL,第2组),并根据分组和性别进行比较。

结果

男性分为第1组(n = 113,68.9%)和第2组(n = 51,31.1%),女性分为第1组(n = 71,58.7%)和第2组(n = 50,41.3%)。多变量分析显示,第2组男性的增强指数(71.0[校正均值]±1.7[标准误]对78.8±2.5%,P = 0.045)、中心收缩压(SBP)(143.3±2.1对153.0±3.2 mmHg,P = 0.013)、体循环血管阻力(SVR,21.4±0.6对23.9±0.9 mmHg/L/min,P = 0.027)、日间SBP(144.1±1.4对151.6±2.1 mmHg,P = 0.004)和夜间SBP(130.4±1.6对138.5±2.5 mmHg,P = 0.008)以及夜间脉压(PP,47.2±0.9对51.7±1.4 mmHg,P = 0.010)显著更高,而心输出量(5.4±0.1对4.8±0.2L/min,P = 0.043)和PP放大率(1.02±0.02对0.94±0.03,P = 0.039)显著低于第1组男性。然而,两组女性之间无显著差异。

结论

与TSH略低于正常范围组相比,初次接受治疗的TSH略高于正常范围且甲状腺功能正常的高血压男性表现出更高的动脉僵硬度、中心SBP、SVR以及ABPM中的SBP,且心输出量和PP放大率更低,但女性并非如此。

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