Schillaci G, Verdecchia P, Borgioni C, Ciucci A, Porcellati C
Divisione di Medicina, Ospedale Beato G. Villa, Città della Pieve, Italy.
Am J Hypertens. 1998 May;11(5):515-22. doi: 10.1016/s0895-7061(97)00413-5.
Blood pressure (BP) variability could induce detrimental effects on left ventricular (LV) structure in hypertension. We investigated the association between short-term BP variability, assessed with 24-h noninvasive ambulatory BP monitoring, and LV mass at echocardiography in 1822 untreated subjects (953 men, 869 women) with essential hypertension (EH). The standard deviation (SD) of daytime and night-time systolic BP (SBP, r = 0.13/0.10; both P < .001), but not of diastolic BP, showed a weak correlation with LV mass. Because the SD of daytime SBP showed a direct association with average 24-h SBP (r = 0.27), subjects were ranked into quartiles of the distribution of 24-h SBP. For each quartile, the subjects with SD of daytime (and night-time) SBP below or above the median were classified at low or high BP variability. In both genders, subjects with high daytime SBP variability were older than those at low variability (both P < .01). Within each quartile, LV mass did not differ between the groups at low v those at high SBP variability. Overall, age-adjusted LV mass index was 115 and 115 g/m2 in men at low and high daytime SBP variability (P = .84), and 116 and 114 g/m2 in men at low and high nighttime SBP variability (P = .31). The corresponding values in women were 98 and 99 g/m2 (P = .53) and 98 and 99 g/m2 (P = .64). In conclusion, when the effects of age, gender, and average 24-h BP are taken into account, short-term BP variability assessed with noninvasive monitoring is unrelated to LV mass in subjects with EH.
血压(BP)变异性可能会对高血压患者的左心室(LV)结构产生有害影响。我们在1822名未经治疗的原发性高血压(EH)患者(953名男性,869名女性)中,通过24小时无创动态血压监测评估短期血压变异性,并通过超声心动图测量左心室质量,研究两者之间的关联。日间和夜间收缩压(SBP)的标准差(SD)与左心室质量呈弱相关性(r = 0.13/0.10;P均<0.001),而舒张压的标准差与左心室质量无相关性。由于日间SBP的SD与24小时平均SBP呈直接关联(r = 0.27),因此将受试者按24小时SBP分布的四分位数进行排序。对于每个四分位数,将日间(和夜间)SBP标准差低于或高于中位数的受试者分为低或高血压变异性组。在男女两性中,日间SBP变异性高的受试者比变异性低的受试者年龄更大(P均<0.01)。在每个四分位数内,低SBP变异性组和高SBP变异性组的左心室质量无差异。总体而言,在日间SBP变异性低和高的男性中,年龄调整后的左心室质量指数分别为115和115 g/m²(P = 0.84),在夜间SBP变异性低和高的男性中分别为116和114 g/m²(P = 0.31)。女性的相应值分别为98和99 g/m²(P = 0.53)以及98和99 g/m²(P = 0.64)。总之,在考虑年龄、性别和24小时平均血压的影响后,通过无创监测评估的短期血压变异性与EH患者的左心室质量无关。