绝经后女性高血压患者24 h动态血压变异性研究
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摘要
目的研究绝经后女性高血压患者24 h动态血压变异性。方法选取2015年6月~2017年6月于我院就诊的163例绝经后女性原发性高血压患者为研究对象。根据动态血压监测结果,按血压昼夜节律划分为勺型组(n=18)、非勺型组(n=87)和反勺型组(n=58)。收集两组患者临床基线资料,并进行24 h动态血压监测。结果反勺型组患者的绝经年龄显著早于勺型组(P<0.05);多因素Logistic回归分析结果显示,绝经年龄是反勺型血压形成的独立危险因素(OR=1.148;95%CI=1.020~1.292;P=0.020);通过更进一步的发现,绝经年龄与夜间血压下降率成负相关(收缩压r=-0.159,P<0.05;舒张压r=-0.161,P<0.05)。结论女性绝经后高血压患者中,绝经年龄是反勺型高血压的独立危险因素。
Objective To study postmenopausal women with hypertension 24 hours ambulatory blood pressure variability. Methods A total of 163 patients with female postmenopausal hypertension admitted in our hospital from June 2015 to June 2017 were selected. Based on the results of ambulatory blood pressure monitoring, the patients were divided into dipper groups(n=18), non-dipper groups(n=87)and anti-dipper groups(n=58). The baseline data of three groups were collected and conducted the 24 h ambulatory blood pressure monitoring. Results The menopausal age of the antidipper group was significantly earlier the dipper group(P<0.05). Multivariate Logistic regression analysis showed that the menopausal age was an independent risk factor for the formation of anti-dipper blood pressure(OR=1.148; 95%CI=1.020-1.292; P=0.020). Furthermore, the menopausal age was negatively correlated with nocturnal BP decline(SBP r=-0.159, P <0.05; DBP r =-0.161 P <0.05). Conclusion The menopausal age is an independent risk of reversal of blood pressure for the formation of anti-dipper blood pressure in postmenopausal hypertensive patients.
Objective To study postmenopausal women with hypertension 24 hours ambulatory blood pressure variability. Methods A total of 163 patients with female postmenopausal hypertension admitted in our hospital from June 2015 to June 2017 were selected. Based on the results of ambulatory blood pressure monitoring, the patients were divided into dipper groups(n=18), non-dipper groups(n=87)and anti-dipper groups(n=58). The baseline data of three groups were collected and conducted the 24 h ambulatory blood pressure monitoring. Results The menopausal age of the antidipper group was significantly earlier the dipper group(P<0.05). Multivariate Logistic regression analysis showed that the menopausal age was an independent risk factor for the formation of anti-dipper blood pressure(OR=1.148; 95%CI=1.020-1.292; P=0.020). Furthermore, the menopausal age was negatively correlated with nocturnal BP decline(SBP r=-0.159, P <0.05; DBP r =-0.161 P <0.05). Conclusion The menopausal age is an independent risk of reversal of blood pressure for the formation of anti-dipper blood pressure in postmenopausal hypertensive patients.
引文
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[19]Park S.Age at first childbirth and hypertension in postmenopausal women[J].Hypertension,2017,69(5):821-826.
[20]Schillaci G,Battista F,Settimi L,et al.Antihypertensive drug treatment and circadian blood pressure rhythm:A review of the role of chronotherapy in hypertension[J].Curr Pharm Des,2015,21(6):756-772.
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[22]Sun L,Yan B,Gao Y,et al.Relationship between blood pressure reverse dipping and type 2 diabetes in hypertensive patients[J].Sci Rep,2016,6:250-253.
[23]Verdecchia P,Porcellati C,Schillaci G,et al.Ambulatory blood pressure.An independent predictor of prognosis in essential hypertension[J].Hypertension,1994,24(6):793-801.
[24]Wang C,Ye Z,Li Y,et al.Prognostic value of reverse dipper blood pressure pattern in chronic kidney disease patients not undergoing dialysis:Prospective cohort study[J].Sci Rep,2016,6:34932.
[25]Yan B,Peng L,Dong Q,et al.Reverse-dipper pattern of blood pressure may predict lacunar infarction in patients with essential hypertension[J].Eur J Neurol,2015,22(6):1022-1025.
[26]Yeasmin N,Akhter QS,Mahmuda S,et al.Association of hypertension with serum estrogen level in postmenopausal women[J].Mymensingh Med J,2017,26(3):635-641.
[27]曾哲,许曼燕,孟令英,等.绝经后高血压患者雌激素水平与血压昼夜节律变化及血管内皮功能的相关性[J].中国临床研究,2016,29(8):1062-1066.
[28]陈源源.围绝经期高血压[J].中华老年心脑血管病杂志,2017,19(6):670-672.
[29]Zhou Y,Zhou X,Guo X,et al.Prevalence and risk factors of hypertension among pre-and post-menopausal women:A cross-sectional study in a rural area of northeast China[J].Maturitas,2015,80(3):282-287.
[2]Benjamin EJ,Blaha MJ,Chiuve SE,et al.Heart disease and stroke statistics-2017 update:A report from the American heart association[J].Circulation,2017,135(10):e146-e603.
[3]Ebong IA,Watson KE,Goff DC,et al.Age at menopause and incident heart failure:The multi-ethnic study of atherosclerosis[J].Menopause,2014,21(6):585-591.
[4]Kannel WB,Hjortland MC,Mc Namara PM,et al.Menopause and risk of cardiovascular disease:The Framingham study[J].Ann Intern Med,1976,85(4):447-452.
[5]Muka T,Oliver-Williams C,Kunutsor S,et al.Association of age at onset of menopause and time since onset of menopause with cardiovascular outcomes,intermediate vascular traits,and all-cause mortality:A sys tematic review and Meta-analysis[J].JAMA Cardiol,2016,1(7):767-776.
[6]Ahbap E,Sakaci T,Kara E,et al.The relationship between serum albumin levels and 24-h ambulatory blood pressure monitoring recordings in non-diabetic essential hypertensive patients[J].Clinics(Sao Paulo),2016,71(5):257-263.
[7]Sengul A,Rasier R,Ciftci C,et al.Short-term effects of intravitreal ranibizumab and bevacizumab administration on 24-h ambulatory blood pressure monitoring recordings in normotensive patients with age-related macular degeneration[J].Eye(Lond),2017;31(5):677-683.
[8]Bouhanick B,Bongard V,Amar J,et al.Prognostic value of nocturnal blood pressure and reverse-dipping status on the occurrence of cardiovascular events in hypertensive diabetic patients[J].Diabetes Metab,2008,34(6):560-567.
[9]Oliveira GMM,Mendes M,Malachias MVB,et al.2017Guidelines for the management of arterial hypertension in primary health care in Portuguese-speaking countries[J].Rev Port Cardiol,2017,36(11):789-798.
[10]Yan B,Peng L,Dong Q,et al.Reverse-dipper pattern of blood pressure may predict lacunar infarction in patients with essential hypertension[J].Eur J Neurol,2015,22(6):1022-1025.
[11]Auerbach BJ,Littman AJ,Tinker L,et al.Associations of100%fruit juice versus whole fruit with hyper tension and diabetes risk in postmenopausal women:Results from the women's health initiative[J].Prev Med,2017,105:212-218.
[12]Ben-Dov IZ,Kark JD,Ben-Ishay D,et al.Predictors of all-cause mortality in clinical ambulatory monitoring:Unique aspects of blood pressure during sleep[J].Hypertension,2007,49(6):1235-1241.
[13]Han J,Gao Y,Guo Q,et al.Cross-sectional study on the relationship between the level of serum cystatin C and blood pressure reverse dipping in hypertensive patients[J].BMJ Open,2016,6(9):e011166.
[14]Head GA.The importance and prognostic value of nocturnal blood pressure assessments using inexpensive domestic devices[J].J Hypertens,2017,35(3):463-465.
[15]Honda T,Eliot MN,Eaton CB,et al.Long-term exposure to residential ambient fine and coarse particulate matter and incident hypertension in post-menopausal women[J].Environ Int,2017,105:79-85.
[16]Johnson SA,Feresin RG,Navaei N,et al.Effects of daily blueberry consumption on circulating biomarkers of oxidative stress,inflammation,and antioxidant defense in postmenopausal women with pre-and stage 1-hypertension:a randomized controlled trial[J].Food Funct,2017,8(1):372-80.
[17]Kingsley SL,Eliot MN,Whitsel EA,et al.Residential proximity to major roadways and incident hypertension in post-menopausal women[J].Environ Res,2015,142:522-528.
[18]Muchanga M,Lepira FB,Tozin R,et al.Prevalence and risk factors of pre-hypertension in Congolese pre and post menopausal women[J].Afr Health Sci,2016,16(4):979-985.
[19]Park S.Age at first childbirth and hypertension in postmenopausal women[J].Hypertension,2017,69(5):821-826.
[20]Schillaci G,Battista F,Settimi L,et al.Antihypertensive drug treatment and circadian blood pressure rhythm:A review of the role of chronotherapy in hypertension[J].Curr Pharm Des,2015,21(6):756-772.
[21]Son WM,Sung KD,Cho JM,et al.Combined exercise reduces arterial stiffness,blood pressure,and blood markers for cardiovascular risk in postmenopausal women with hypertension[J].Menopause,2017,24(3):262-268.
[22]Sun L,Yan B,Gao Y,et al.Relationship between blood pressure reverse dipping and type 2 diabetes in hypertensive patients[J].Sci Rep,2016,6:250-253.
[23]Verdecchia P,Porcellati C,Schillaci G,et al.Ambulatory blood pressure.An independent predictor of prognosis in essential hypertension[J].Hypertension,1994,24(6):793-801.
[24]Wang C,Ye Z,Li Y,et al.Prognostic value of reverse dipper blood pressure pattern in chronic kidney disease patients not undergoing dialysis:Prospective cohort study[J].Sci Rep,2016,6:34932.
[25]Yan B,Peng L,Dong Q,et al.Reverse-dipper pattern of blood pressure may predict lacunar infarction in patients with essential hypertension[J].Eur J Neurol,2015,22(6):1022-1025.
[26]Yeasmin N,Akhter QS,Mahmuda S,et al.Association of hypertension with serum estrogen level in postmenopausal women[J].Mymensingh Med J,2017,26(3):635-641.
[27]曾哲,许曼燕,孟令英,等.绝经后高血压患者雌激素水平与血压昼夜节律变化及血管内皮功能的相关性[J].中国临床研究,2016,29(8):1062-1066.
[28]陈源源.围绝经期高血压[J].中华老年心脑血管病杂志,2017,19(6):670-672.
[29]Zhou Y,Zhou X,Guo X,et al.Prevalence and risk factors of hypertension among pre-and post-menopausal women:A cross-sectional study in a rural area of northeast China[J].Maturitas,2015,80(3):282-287.