Solanki Jayesh D, Mehta Hemant B, Panjwani Sunil J, Munshi Hirava B, Shah Chinmay J
Department of Physiology, Govt. Medical College, Bhavnagar, Gujarat, India.
Department of Medicine, Govt. Medical College, Bhavnagar, Gujarat, India.
J Family Med Prim Care. 2019 Jun;8(6):2047-2054. doi: 10.4103/jfmpc.jfmpc_233_19.
Hypertension is the most prevalent noncommunicable disorder, studied in terms of brachial blood pressure. Direct parameters like central hemodynamics and arterial stiffness, though superior, are not studied much. The same can be studied by pulse-wave analysis (PWA) and we did that in euglycemic treated hypertensives.
A case-control study was conducted in 258 treated euglycemic hypertensives and 258 matched controls. Oscillometric PWA was accomplished by Mobil-O-Graph (IEM, Germany). Parameters were further analyzed for the effect of gender, physical activity, body mass index (BMI) (cutoff 23), blood pressure control, and duration (cutoff 5 years). Multiple linear regressions were used to find significant predictors. < 0.05 was taken as statistically significant.
Cases had significantly higher brachial arterial parameters (blood pressure, heart rate, rate pressure product), arterial stiffness (augmentation pressure, augmentation index, pulse-wave velocity, total arterial stiffness, pulse pressure amplification), and central hemodynamics (central blood pressure, cardiac output, stroke work) compared to age, gender, and BMI-matched controls. In the case group, female gender, BMI ≥ 23, and uncontrolled blood pressure were significant factors affecting results. Heart rate and pulse pressure were major predictors of study parameters. Central pressure parameters were not predicted significantly by corresponding brachial pressure parameters.
PWA revealed the adverse profile of arterial stiffness and central hemodynamics in treated Gujarati hypertensives, associated with female gender, BMI, and blood pressure control, predicted mainly by heart rate and pulse pressure, independent of brachial blood pressure. It indicates both potential and further study of these parameters.
高血压是最常见的非传染性疾病，通常是根据肱动脉血压进行研究。虽然诸如中心血流动力学和动脉僵硬度等直接参数更为优越，但相关研究却不多。可以通过脉搏波分析（PWA）来研究这些参数，我们对血糖正常的高血压患者进行了此项研究。
对258例接受治疗的血糖正常的高血压患者和258例匹配的对照者进行了一项病例对照研究。采用德国IEM公司的Mobil-O-Graph进行示波法脉搏波分析。进一步分析了性别、身体活动、体重指数（BMI）（临界值23）、血压控制和病程（临界值5年）对各项参数的影响。采用多元线性回归分析来找出显著的预测因素。P<0.05被视为具有统计学意义。
与年龄、性别和BMI匹配的对照组相比，病例组的肱动脉参数（血压、心率、率压乘积）、动脉僵硬度（增强压、增强指数、脉搏波速度、总动脉僵硬度、脉压放大）和中心血流动力学（中心血压、心输出量、每搏功）显著更高。在病例组中，女性、BMI≥23以及血压未得到控制是影响结果的重要因素。心率和脉压是研究参数的主要预测因素。相应的肱动脉压力参数并不能显著预测中心压力参数。
脉搏波分析揭示了接受治疗的古吉拉特高血压患者存在动脉僵硬度和中心血流动力学不良情况，这与女性性别、BMI和血压控制有关，主要由心率和脉压预测，独立于肱动脉血压。这表明了这些参数的潜在价值及需要进一步研究。
