正常血压者血压变异性与血压节律的相关性

The relationship between blood pressure variability and circadiam rhythm in normotensives

  • 摘要: 目的探讨正常血压者血压变异性特点及其与血压昼夜节律、年龄和性别的关系。方法选择2002年1月至2011年12月在福建医科大学附属第一医院门诊(或体检中心)检查动态血压的正常血压者1024人。收集动态血压相关数据,分析24h血压标准差(24hBPSD)、白天血压标准差(dBPSD)、夜间血压标准差(nBPSD)、24h血压加权标准差(24hBPWSD)。采用血压标准差、变异系数来表示血压变异性,采用公式(白天平均收缩压-夜间平均收缩压)/白天平均收缩压计算夜间血压下降率,根据夜间血压下降率分为反杓型、非杓型、杓型和超杓型;按年龄分为<40、40~<50、50~<60、≥60岁。结果正常血压人群反杓型、非杓型、杓型和超杓型的比例分别为6.0%、47.0%、43.6%、3.4%。正常血压人群24 h收缩压标准差为(12.8±3.4)mm Hg;24 h舒张压标准差为(9.1±2.2)mm Hg;24h收缩压变异系数为0.11±0.03;24h舒张压变异系数0.13±0.03。反杓型、非杓型、杓型、超杓型组24hBPSD、dBPSD、24hBPWSD逐渐增加,除反杓型与非杓型组外,其他组两两比较,差异有统计学意义(均P<0.05),而4组nBPSD比较,差异无统计学意义(均P>0.05)。24h、白天和夜间收缩压标准差随着年龄增加而升高(P<0.05),而舒张压标准差差异无统计学意义(P>0.05);男性较女性血压变异性高,但差异无统计学意义(P>0.05)。结论正常血压人群杓型和超杓型血压变异性高于非杓型或反杓型。随着年龄增大,收缩压变异性逐渐增大,而与性别无明显相关。

     

    Abstract: Objective To investigate the characteristics of blood pressure variability and relationship between blood pressure circadian rhythm and age,gender in normotensives. Methods A total of 1024 out-patients who visited our clinic from January 2002 to December 2011 with normal blood pressure confirmed by 24 h-ambulatory blood pressure monitoring were enrolled in the study. The data of ambulatory blood pressure monitoring was collected and the standard deviations for 24 hblood pressure(24 hBPSD),daytime blood pressure(dBPSD),nighttime blood pressure(nBPSD)and 24 hblood pressure weighted standard deviation(24 hBPWSD)were analyzed. The standard deviation and coefficient of variation were used to represent the blood pressure variability. The nocturnal BP reduction rate was calculated by the formula:(daytime average systolic blood pressure-nighttime average systolic blood pressure)/daytime average systolic blood pressure.Patients were divided into anti-dipper,non-dipper,dipper and ultradipper group according to the nocturnal BP reduction rate and into <40,40-<50,50-<60 and >60 years old group according to the age. Results In normotensives,the percentages of anti-dipper,non-dipper,dipper and ultra-dipper were 6.0%,47.0%,43.6% and 3.4% respectively,and the standard deviations for 24 hsystolic blood pressure and for 24 hdiastolic blood pressure were(12.8±3.4)and(9.1±2.2)mm Hg,and the coefficient of variability of 24 hsystolic blood pressure and for 24 hdiastolic blood pressure were 0.11±0.03 and 0.13±0.03,respectively. 24 hBPSD,dBPSD and 24 hBPWSD in four groups(anti-dipper,non-dipper,dipper and ultra-dipper)increased along with the rising of nocturnal BP reduction rate and there was statistically significant difference(P<0.05)in group pairwise comparison except for anti-dipper and non-dipper groups.While the difference was not statistically significant for nBPSD(P>0.05).24 h,diurnal and nocturnal systolic blood pressure standard deviation rose with the increasing of age(P<0.05),but the difference was not statistically significant for diastolic blood pressure standard deviation(P>0.05). Blood pressure variability in male group was higher than female group,but the difference was not statistically significant(P>0.05).Conclusion In normotensive population,blood pressure variability in anti-dipper and non-dipper groups were lower than dipper and ultra-dipper groups.Systolic blood pressure variability gradually increased with age but not gender in normal blood pressure population.

     

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