Zhang Y N, Chen T L, Geng X, Gu G Q, Zheng H M, Yang X H, Zhang J D, Xie R Q, Cui W
First Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.
Zhonghua Yi Xue Za Zhi. 2018 Sep 4;98(33):2641-2644. doi: 10.3760/cma.j.issn.0376-2491.2018.33.006.
To explore the prevalence and clinical characteristics of postprandial hypotension(PPH) in patients with essential hypertension and coronary heart disease. A total of 197 patients with essential hypertension and coronary heart disease, who had been treated in the First Department of Cardiology of the Second Hospital of Hebei Medical University from December, 2013 to December, 2014 were included. The patients' blood pressure before breakfast, lunch and dinner and 30, 60, 90, 120 minutes after the meal were monitored. Subjects were classified into PPH group (=37) and non-PPH group (NPPH, =160) according to postprandial decrease in systolic blood pressure, to explore the clinical characteristics and related factors and the major adverse cardiac and cerebral vascular events of PPH. Among 197 patients, 37 cases (18.8%) showed at least once postprandial decline in systolic blood pressure greater than and equal to 20 mmHg. The incidence of PPH after breakfast and dinner were higher than lunch (<0.05). There was no significant difference in the incidence of PPH among different age groups, among patients accompanied with different diseases, and among patients with different dining position (all >0.05). According to the baseline systolic blood pressure, patients can be divided into 4 groups(<120 mmHg, 120-129 mmHg, 130-139 mmHg, >140 mmHg), the higher the level of the baseline systolic blood pressure was, the higher the incidence of PPH was. And the incidence of major adverse cardiac and cerebral vascular events in patients during hospitalization were increased by PPH. The prevalence of PPH in the patients with essential hypertension and coronary heart disease is 18.8%. The incidence of PPH after breakfast and dinner is higher than lunch. The baseline systolic blood pressure is considered to be the risk factor of PPH. And PPH could lead to an increase of the incidence of major adverse cardiac and cerebral vascular events.
探讨原发性高血压合并冠心病患者餐后低血压（PPH）的患病率及临床特征。纳入2013年12月至2014年12月在河北医科大学第二医院心内科一病区接受治疗的197例原发性高血压合并冠心病患者。监测患者早餐、午餐和晚餐前及餐后30、60、90、120分钟的血压。根据餐后收缩压下降情况将受试者分为PPH组（n = 37）和非PPH组（NPPH，n = 160），以探讨PPH的临床特征、相关因素及主要心脑血管不良事件。197例患者中，37例（18.8%）出现至少一次餐后收缩压下降≥20 mmHg。早餐和晚餐后PPH的发生率高于午餐（P<0.05）。不同年龄组、合并不同疾病的患者及不同就餐体位的患者PPH发生率差异均无统计学意义（均P>0.05）。根据基线收缩压，患者可分为4组（<120 mmHg、120 - 129 mmHg、130 - 139 mmHg、>140 mmHg），基线收缩压水平越高，PPH发生率越高。PPH增加了患者住院期间主要心脑血管不良事件的发生率。原发性高血压合并冠心病患者中PPH的患病率为18.8%。早餐和晚餐后PPH的发生率高于午餐。基线收缩压被认为是PPH的危险因素。且PPH可导致主要心脑血管不良事件发生率增加。
