高血压患者中血压及血压变异性与慢性下腰痛的关系
Blood Pressure and Blood Pressure Variability in Relation to Chronic Low Back Pain Among Patients with Hypertension.
作者信息
Skrzypek Maciej, Słaboszewski Michał, Kolec Rafał, Wojciechowska Wiktoria, Olszanecka Agnieszka, Wróbel Piotr, Polak Maciej, Stolarz-Skrzypek Katarzyna, Rajzer Marek W
机构信息
Department of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Kraków, Poland.
Students Scientific Group, First Department of Cardiology, Interventional Electrocardiology and Hypertension, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Kraków, Poland.
出版信息
Healthcare (Basel). 2025 May 16;13(10):1166. doi: 10.3390/healthcare13101166.
INTRODUCTION
Chronic pain which tends to be localised particularly in the lower back and lower extremities is one of the risk factors for elevated blood pressure (BP). In this cross-sectional study, we evaluated whether chronic low back pain (cLBP) is associated with BP variability, which may be related to increased mortality and morbidity.
METHODS
We included 85 consecutive hypertensive patients with a median age of 62 years (IQR, 55-67) with cLBP, for which intensity was assessed using the Oswestry Disability Index (ODI). Ambulatory blood pressure monitoring (ABPM) was performed to evaluate the values and variability of systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) over 24 h, day- and nighttime BP variability assessed as BP standard deviation (SD).
RESULTS
In the whole study population, the median ODI questionnaire score was 16 (IQR, 11-20). Patients with an equal/higher than median ODI score had lower nighttime DBP compared with other patients ( = 0.028). Equal/higher than median ODI score correlated with 24 h SD values for SBP and MAP (r = 0.263; = 0.016, and r = 0.229; = 0.036, respectively), as well as with day-night differences in SBP (r = 0.229; = 0.035), DBP (r = 0.253; = 0.019), and MAP (r = 0.263; = 0.015). We performed a multivariate regression analysis adjusted for potential confounders, and equal/higher than median ODI score was predicted by age (OR, 1.07; 95% CI, 1.006-1.14; = 0.031) and day-night DBP difference (OR 1.07; 95% CI 1.002-1.15; = 0.044).
CONCLUSIONS
To our knowledge, this is the first study to show that more intense cLBP is associated with BP variability among patients with hypertension.
引言
慢性疼痛往往局限于下背部和下肢，是血压升高的危险因素之一。在这项横断面研究中，我们评估了慢性下腰痛（cLBP）是否与血压变异性相关，而血压变异性可能与死亡率和发病率增加有关。
方法
我们纳入了85例连续的高血压患者，中位年龄为62岁（四分位间距，55 - 67岁），患有cLBP，使用奥斯维斯特里功能障碍指数（ODI）评估其疼痛强度。进行动态血压监测（ABPM）以评估收缩压（SBP）、舒张压（DBP）和平均动脉压（MAP）在24小时内的值和变异性，日间和夜间血压变异性以血压标准差（SD）评估。
结果
在整个研究人群中，ODI问卷的中位得分为16（四分位间距，11 - 20）。ODI得分等于或高于中位数的患者与其他患者相比，夜间DBP较低（P = 0.028）。ODI得分等于或高于中位数与SBP和MAP的24小时SD值相关（r = 0.263；P = 0.016，以及r = 0.229；P = 0.036），也与SBP（r = 0.229；P = 0.035）、DBP（r = 0.253；P = 0.019）和MAP（r = 0.263；P = 0.015）的昼夜差异相关。我们进行了多变量回归分析以校正潜在混杂因素，年龄（比值比，1.07；95%置信区间，1.006 - 1.14；P = 0.031）和昼夜DBP差异（比值比1.07；95%置信区间1.002 - 1.15；P = 0.044）可预测ODI得分等于或高于中位数。
结论
据我们所知，这是第一项表明在高血压患者中，更严重的cLBP与血压变异性相关的研究。
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