Khattar R S, Acharya D U, Kinsey C, Senior R, Lahiri A
Cardiology Department, Northwick Park Hospital, Harrow, Middlesex, UK.
J Hypertens. 1997 Jul;15(7):737-43. doi: 10.1097/00004872-199715070-00005.
To determine the longitudinal relationship between clinic and ambulatory blood pressures and subsequent left ventricular and carotid artery structure.
A retrospective follow-up study.
A large district general hospital in Harrow, UK.
One hundred and forty patients who had been subjected to 24 h ambulatory intra-arterial blood pressure monitoring on the basis of their having an elevated clinic blood pressure were followed up randomly a mean of 9.4 +/- 3.4 years later. The ambulatory blood pressure parameters measured were the mean systolic, mean diastolic and mean pulse pressures. Follow-up variables assessed included the clinic blood pressure, body mass index, total cholesterol, number of years of follow-up, left ventricular mass index, carotid intima-media thickness and carotid artery cross-sectional area.
The left ventricular mass index, carotid intima-media thickness and carotid artery cross-sectional area.
The mean pulse pressure and mean systolic blood pressure were correlated significantly with the left ventricular mass index (r = 0.46, P < 0.001 and r = 0.36, P < 0.001, respectively), carotid intima-media thickness (r = 0.45, P < 0.001 and r = 0.37, P < 0.001, respectively) and carotid artery cross-sectional area (r = 0.46, P < 0.001 and r = 0.41, P < 0.001, respectively). The mean pulse pressure was associated independently with all three outcome measures. In addition, the body mass index was an independent determinant of the left ventricular mass index, whereas the serum cholesterol level was associated independently with the carotid artery cross-sectional area; the number of years of follow-up was related independently to the left ventricular mass index and carotid intima-media thickness, but not to the cross-sectional area.
These findings suggest that ambulatory blood pressure monitoring can play a role in guiding the choice of doses in drug therapy to limit potential target organ damage.
确定诊室血压与动态血压之间的纵向关系以及随后的左心室和颈动脉结构。
一项回顾性随访研究。
英国哈罗的一家大型地区综合医院。
140名患者，因其诊室血压升高接受了24小时动态动脉内血压监测，平均9.4±3.4年后进行随机随访。测量的动态血压参数包括平均收缩压、平均舒张压和平均脉压。评估的随访变量包括诊室血压、体重指数、总胆固醇、随访年限、左心室质量指数、颈动脉内膜中层厚度和颈动脉横截面积。
左心室质量指数、颈动脉内膜中层厚度和颈动脉横截面积。
平均脉压和平均收缩压与左心室质量指数显著相关（分别为r = 0.46，P < 0.001和r = 0.36，P < 0.001）、颈动脉内膜中层厚度（分别为r = 0.45，P < 0.001和r = 0.37，P < 0.001）以及颈动脉横截面积（分别为r = 0.46，P < 0.001和r = 0.41，P < 0.001）。平均脉压与所有三项观察指标均独立相关。此外，体重指数是左心室质量指数的独立决定因素，而血清胆固醇水平与颈动脉横截面积独立相关；随访年限与左心室质量指数和颈动脉内膜中层厚度独立相关，但与横截面积无关。
这些发现表明，动态血压监测可在指导药物治疗剂量选择以限制潜在靶器官损害方面发挥作用。
