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胡巴尔一家三级护理医院的水合状态与血压评估

Assessment of Hydration Status and Blood Pressure in a Tertiary Care Hospital at Al-Khobar.

作者信息

Mohammedin Ahmed S, AlSaid Abir H, Almalki Abdulaziz M, Alsaiari Abdulkarim R, Alghamdi Fahad N, Jalalah Alwaleed A, Alghamdi Abdulaziz F, Jatoi Noor-Ahmed

机构信息

Internal Medicine, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University Hospital, Al-Khobar, SAU.

Geriatric Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, EGY.

出版信息

Cureus. 2022 Aug 5;14(8):e27706. doi: 10.7759/cureus.27706. eCollection 2022 Aug.

Abstract

Background High blood pressure is a major cardiovascular risk factor. It is a leading cause of increasing morbidity and mortality worldwide. One-third of the adult population worldwide suffers from hypertension. Salt intake, obesity, decreased physical activity, and smoking are well known to increase blood pressure. Fluid retention is the main contributing factor to primary hypertension and adversely affects the cardiovascular system. The emerging evidence suggests a relationship between blood pressure and hydration status. Our study aims to assess the correlation between hydration status and blood pressure. We aim to assess the hydration status in subjects with normal and high blood pressure and to investigate the association of hydration status with hemodynamic measurement. Methodology This cross-sectional and observational study included adult (>18 years) male and female subjects who agreed to participate. In total, 235 subjects were recruited by convenience sampling from (1) patients and caregivers attending geriatric and internal medicine clinics, and (2) visitors coming to King Fahad University Hospital at Al-Khobar. There were five patients on oral diuretics who were excluded from the study. Data were collected from September 2021 to March 2022. Hydration status was measured by a bioelectrical impedance analyzer (Bioscan 920, Maltron International Ltd. Rayleigh, UK). Hemodynamic measurements included heart rate per minute, systolic blood pressure, diastolic blood pressure, pulse pressure (the difference between systolic and diastolic blood pressure), and mean arterial pressure calculated as blood diastolic pressure plus one-third of pulse pressure. Statistical analyses were performed using SPSS statistics for windows, version 28.0 (IBM Corp., Armonk, NY, USA). Descriptive data were reported using means with standard deviations for numerical data and relative frequencies (percentage) for categorical data. P-values of less than 0.05 were considered statistically significant. Comparison between groups was done using a one-way analysis of variance test. Results Extracellular water percentage was higher in hypertensive (45.0 ± 2) than prehypertensive (43.5 ± 3) or normotensive (43.0 ± 2) (p = 0.001) subjects. In contrast, intracellular water percentage and total body water percentage were significantly negatively related to hypertension status. Conclusions Our results have shown a strong association between hypertension status and hydration parameters. In our study, hypertensive subjects tended to have lower total body water percentage and intracellular water percentage (bioimpedance value) than normotensive subjects. This might promote more research regarding the relationship between hypohydration and cardiovascular disease pathophysiology. This outcome should raise awareness about proper hydration as hypohydration can be a causative factor for hypertension.

摘要

背景

高血压是主要的心血管危险因素。它是全球发病率和死亡率上升的主要原因。全球三分之一的成年人口患有高血压。众所周知,盐摄入、肥胖、体力活动减少和吸烟会导致血压升高。液体潴留是原发性高血压的主要促成因素,并对心血管系统产生不利影响。新出现的证据表明血压与水合状态之间存在关联。我们的研究旨在评估水合状态与血压之间的相关性。我们旨在评估血压正常和血压高的受试者的水合状态,并研究水合状态与血流动力学测量之间的关联。

方法

这项横断面观察性研究纳入了同意参与的成年(>18岁)男性和女性受试者。总共通过便利抽样从以下人群中招募了235名受试者:(1)在老年病科和内科诊所就诊的患者及护理人员,以及(2)来到胡拜尔法赫德国王大学医院的访客。有5名正在服用口服利尿剂的患者被排除在研究之外。数据收集时间为2021年9月至2022年3月。使用生物电阻抗分析仪(Bioscan 920,英国瑞利马尔特隆国际有限公司)测量水合状态。血流动力学测量包括每分钟心率、收缩压、舒张压、脉压(收缩压与舒张压之差)以及通过舒张压加脉压的三分之一计算得出的平均动脉压。使用SPSS for Windows统计软件28.0版(美国纽约州阿蒙克市国际商业机器公司)进行统计分析。数值数据使用均值和标准差报告描述性数据,分类数据使用相对频率(百分比)报告。P值小于0.05被认为具有统计学意义。使用单向方差分析检验进行组间比较。

结果

高血压患者的细胞外水百分比(45.0±2)高于高血压前期患者(43.5±3)或血压正常患者(43.0±2)(p=0.001)。相比之下,细胞内水百分比和总体水百分比与高血压状态显著负相关。

结论

我们的结果表明高血压状态与水合参数之间存在密切关联。在我们的研究中,高血压患者的总体水百分比和细胞内水百分比(生物电阻抗值)往往低于血压正常的受试者。这可能会促使更多关于脱水与心血管疾病病理生理学之间关系的研究。这一结果应提高人们对适当水合的认识,因为脱水可能是高血压的一个致病因素。

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