不同体质量指数老年高血压患者血压水平与臂踝动脉脉搏波传导速度及踝臂血压指数的相关性

梁瑞景; 梁瑞凯

doi:10.16439/j.cnki.1673-7245.2019.06.009

不同体质量指数老年高血压患者血压水平与臂踝动脉脉搏波传导速度及踝臂血压指数的相关性

The correlation of blood pressure level with brachial-ankle pulse wave velocity and ankle brachial index in elderly hypertensive patients with different body mass index

摘要

摘要: 目的探讨不同体质量指数（BMI）老年高血压患者血压水平与臂踝动脉脉搏波传导速度（baPWV）及踝臂血压指数（ABI）的相关性。方法入选2015年5月至2018年5月确诊的老年高血压患者共251例,根据患者的BMI分为正常组（18.5～<24.0）kg/m²和非正常组超重组（24.0～<28.0）kg/m²,轻度肥胖组（28.0～<30.0）kg/m²与重度肥胖组（≥30.0）kg/m²。比较各组患者的血压水平、baPWV及ABI的差异,分析不同BMI老年高血压患者的血压与baPWV及ABI的相关性。结果重度肥胖组患者血压水平高于轻度肥胖组、超重组和正常组（P<0.05）,baPWV水平高于超重组和正常组（P<0.05）;而ABI低于轻度肥胖组、超重组和正常组（P<0.05）;轻度肥胖组患者收缩压与baPWV水平高于超重组和正常组（P<0.05）,而ABI低于超重组和正常组（P<0.05）;超重组患者血压与baPWV水平高于正常组（P<0.05）。Pearson相关性分析结果表明,BMI非正常组患者收缩压与ABI呈负相关（r=-0.565,P<0.01）,与baPWV呈正相关（r=0.532,P<0.01）;舒张压与ABI呈负相关（r=-0.729,P<0.01）,与baPWV呈正相关（r=0.485,P<0.01）。多元线性回归分析表明,BMI、收缩压、舒张压、年龄、吸烟、饮酒、总胆固醇、低密度脂蛋白胆固醇（LDL-C）与高密度脂蛋白胆固醇（HDL-C）是影响baPWV与ABI的主要因素（P<0.05）。结论 BMI非正常组老年高血压患者的收缩压、舒张压与baPWV呈正相关,而与ABI呈负相关。

Abstract: Objective To investigate the correlation between blood pressure levels in elderly hypertensive patients with different body mass index（BMI） and brachial-ankle pulse wave velocity（baPWV） and ankle brachial blood pressure index（ABI）. Methods A total of 251 elderly hypertensive patients diagnosed between May 2015 and May 2018 were enrolled in our hospital. According to BMI, the patients were divided into normal group（BMI 18.5-＜24.0 kg/m~2）, overweight group（24.0-＜28.0 kg/m~2）, obese group（28.0-＜30.0 kg/m~2） and very obese group（≥30.0 kg/m~2）. The blood pressure levels, baPWV and ABI in different BMI groups were compared, and the correlation between blood pressure and baPWV and ABI in different BMI elderly hypertensive patients were analyzed. Results The blood pressure in the very obese group was significantly higher than those in the obese group, the overweight group and the normal group（P＜0.05）. The level of baPWV was significantly higher than that of the overweight group and the normal group（P＜0.05）, while the ABI was significantly lower than that in the obese group, the overweight group and the normal group（P＜0.05）. The systolic blood pressure and baPWV levels in the obese group were significantly higher than those in the overweight group and the normal group（P＜0.05）, while the ABI was significantly lower than that in the overweight group and the normal group（P＜0.05）. The blood pressure and baPWV levels in the overweight group were significantly higher than those in the normal group（P＜0.05）. Pearson correlation analysis showed that, systolic blood pressure was negatively correlated with ABI（r=-0.565, P＜0.01） in patients with non-BMI normal group, and positively correlated with baPWV（r=0.532, P＜0.01）, and the diastolic blood pressure was negatively correlated with ABI（r=-0.729, P＜0.01） and positively correlated with baPWV（r=0.485, P＜0.01）. Multiple linear regression analysis showed that BMI, systolic blood pressure, diastolic blood pressure, age, smoking, alcohol consumption, total cholesterol, low density lipoprotein cholesterol（LDL-C） and high density lipoprotein cholesterol（HDL-C） were the main factors affecting baPWV and ABI（P＜0.05）. Conclusion Systolic blood pressure and diastolic blood pressure were positively correlated with baPWV in elderly patients with BMI abnormalities, but negatively correlated with ABI.

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