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一项调查高血压患者体重指数与血流动力学特征之间关系的回顾性研究。

A Retrospective Study to Investigate the Relationship Between Body Mass Index and Hemodynamic Characteristics in Hypertensive Patients.

作者信息

Xiao Wenqi, Han Ping, Song Liping, Yang Jingwen, Zhou Lin, Deng Xiangning, Ma Zheng J, Lang Yukun, Zhao Hai, Zhao Yuzhuo, Chen Hui, Zhang Wenjing, Huang Huixian, Sun Ningling

机构信息

Department of Cardiology, Beijing Haidian Hospital, Beijing, China.

Department of Cardiology, Peking University Third Hospital, Beijing, China.

出版信息

J Clin Hypertens (Greenwich). 2025 Jan;27(1):e14946. doi: 10.1111/jch.14946. Epub 2024 Dec 10.

Abstract

The relationship between hemodynamic parameters and body mass index (BMI) in the context of blood pressure regulation in hypertension is unclear. Here, we analyzed data from 1368 uncontrolled hypertensive patients, including key hemodynamic indicators such as heart rate (HR), cardiac index (CI), arterial stiffness (AS), systemic vascular resistance index (SVRI), and thoracic blood ratio (TBR). In this cohort, the average BMI across all hypertension patients was 26.859 ± 3.897 (kg/m), with obese patients (BMI ≥ 28 kg/m) averaging 31.01 ± 2.87 kg/m and non-obese (BMI<28 kg/m) averaging 24.70 ± 2.28 kg/m. Younger obese patients exhibited higher diastolic pressures than non-obese peers (p < 0.01). Hemodynamic analysis showed obese patients had increased HR and SVRI but lower CI and AS (p < 0.01). Hypertensive males aged under 60 with obesity displayed a more prominent peripheral vascular phenotype (p < 0.05) and volemic phenotype (p < 0.01) than non-obese males. Obese females aged under 60 showed a higher incidence of cardiac phenotype (p < 0.01). Across genders, obese hypertensive patients aged over 60 had a greater prevalence of volemic phenotype than non-obese patients (p < 0.05, p < 0.01, respectively). BMI inversely correlated with CI and positively with SVRI across age and gender categories (p < 0.01). Taken together, we find that patients with hypertension exhibit diverse hemodynamic profiles, and BMI significantly correlates with hemodynamic parameters such as SVRI and CI. Our research identifies BMI as a valuable target for personalized hypertension treatment.

摘要

在高血压血压调节背景下,血流动力学参数与体重指数(BMI)之间的关系尚不清楚。在此,我们分析了1368例未控制的高血压患者的数据,包括关键血流动力学指标,如心率(HR)、心脏指数(CI)、动脉僵硬度(AS)、全身血管阻力指数(SVRI)和胸血比(TBR)。在该队列中,所有高血压患者的平均BMI为26.859±3.897(kg/m),肥胖患者(BMI≥28 kg/m)平均为31.01±2.87 kg/m,非肥胖患者(BMI<28 kg/m)平均为24.70±2.28 kg/m。年轻肥胖患者的舒张压高于非肥胖同龄人(p<0.01)。血流动力学分析显示,肥胖患者的HR和SVRI升高,但CI和AS降低(p<0.01)。60岁以下肥胖的高血压男性比非肥胖男性表现出更显著的外周血管表型(p<0.05)和血容量表型(p<0.01)。60岁以下肥胖女性的心脏表型发生率更高(p<0.01)。在所有性别中,60岁以上肥胖高血压患者的血容量表型患病率高于非肥胖患者(分别为p<0.05,p<0.01)。在所有年龄和性别类别中,BMI与CI呈负相关,与SVRI呈正相关(p<0.01)。综上所述,我们发现高血压患者表现出不同的血流动力学特征,且BMI与SVRI和CI等血流动力学参数显著相关。我们的研究将BMI确定为个性化高血压治疗的一个有价值的靶点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e6a/11773678/8cd5dda76754/JCH-27-e14946-g004.jpg

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