急性心肌梗死患者冠状动脉病变严重性与脉压和脉压指数的关系

目的:探讨急性心肌梗死(AMI)患者冠状动脉病变严重程度与脉压和脉压指数的关系.方法:对185例AMI患者进行冠状动脉造影术,冠状动脉病变严重程度用冠状动脉病变支数和Gensini积分来表示,并测定收缩压(SBP)和舒张压(DBP)并计算脉压(PP)及脉压指数(PPI).结果:与脉压＜65mmHg的患者相比,脉压≥65mmHg的患者冠状动脉3支血管病变的患病率和Gensini积分显著增高(P＜0.01).与PPI＜0.500的患者相比,PPI≥0.500的患者冠状动脉3支血管病变的患病率和Gensini积分亦显著增高(P＜0.01).结论:PP和PPI与AMI患者冠状动脉病变程度密切相关,在临床上具有指导作用.     

老年人脉压指数及相关危险因素研究

目的:探讨老年人脉压指数(PPI)变化特点及其相关危险因素。方法:对唐山市3850名老年人集中体检,按照PPI水平分为四组,分别为≤0.400,0.401～0.500,0.501～0.600和0.600,分析各组血压指标特点及与心脑血管病事件的关系。结果:随着SBP的增加,PPI相应增加(P﹤0.001)。随着PPI水平增加,DBP呈下降趋势(P﹤0.01)。脑卒中和冠心病患病率的增加与PPI水平的提高有关(P﹤0.05)。结论:PPI反映了老年人的血压变化特点,并与心脑血管事件有关。     

老年人脑卒中患病率与脉压水平相关性研究

目的 :探讨老年人的脉压 (PP)变化特点及与脑卒中患病率的关系。方法 :对 385 0名老年人集中体检 ,将PP分为四个层次 ,分别为≤ 60mmHg ,60～ 80mmHg ,80～ 1 0 0mmHg和 >1 0 0mmHg。分析各组血压指标特点及与脑卒中事件的关系。结果 :随着SBP的增加 ,PP相应增加 (P <0 .0 0 1 )。脑卒中患病率的增加与PP水平的提高有关 (P <0 .0 5 )。结论 :PP反映了老年人的血压变化特点 ,并与脑卒中事件有关     

老年人分层脉压与其它血压指标特点及分析

目的:了解老年人的分层脉压情况及其它血压指标的特点.方法:集中体检唐山市3860名60岁以上老年人,将其脉压分为四个层次.分别为≤60mmHg,60～80 mmHg,80～100 mmHg和>100mmHg,分析其脉压及其它血压指标,包括收缩压(SBP)、舒张压(DBP)、平均动脉压(MBP)的特点.结果:在不同脉压层次,随着PP的增加,SBP逐渐增加,分别为132.3±17.6 mmHg、154.8±14.1 mmHg、173.5±15.6 mmHg、194.2±16.9 mmHg,MBP逐渐增加为82.7±13.2 mmHg、83.5±12.1 mmHg、82.6±13.5mmHg、82.1±12.1 mmHg,各组间比较差异著有显著性(P＜0.001),而DBP无明显变化(P＞0.05).结论:老年人PP的增宽与SBP的增加有密切关系.     

老年男性原发性高血压患者脉压与颈动脉狭窄的相关分析

目的：探讨老年男性原发性高血压（EH）患者脉压（PP）与动脉粥样硬化性颈动脉狭窄（CS）的关系。方法：对入选的157例伴有颈动脉粥样硬化的老年男性EH患者行颈动脉超声检查,并收集行颈动脉超声检查前1年内的多次血压水平及临床资料,根据颈动脉狭窄程度分为：CS〈50％组（n=66）及CS≥50％组（n=91）,并进一步将颈动脉狭窄程度分级（I—V级）,分析颈动脉狭窄的危险因素及与脉压的相关性。结果：①CS≥50％组收缩压（SBP）及PP显著高于CS〈50％组,而舒张压（DBP）显著低于CS〈50％组（P〈0．05）,CS≥50％组的独立危险因素是外周动脉疾病（OR：4．543,95％CI：1．415．14．590）及脉压（OR：1．096,95％CI：1．038．1．157）;②CS分级与PP（r=0．402,P〈0．01）及血浆纤维蛋白原（FIB）（r=0．200,P〈0．05）呈正相关,经校正年龄、体重指数（BMI）、SBP、DBP、总胆固醇（TO）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-c）、低密度脂蛋白胆固醇（LDL-c）、D-二聚体（D-dimer）、血尿酸（UA）、空腹血糖（FBG）、氨基酸末端脑利钠肽前体（NT-proBNP）、总胆红素（TBIL）及直接胆红素（DBIL）等危险因素后,CS分级仍与PP及FIB有关。结论：老年男性原发性高血压患者脉压与颈动脉狭窄有关,治疗高血压的同时应当尽量减小脉压。     

成都地区中老年居民血清尿酸相关危险因素分析

目的:分析成都地区中老年居民血清尿酸水平及其影响因素,为防治心脑血管事件提供策略支持。方法:利用2007代谢综合征研究调查资料(共1061人),把人群依据血尿酸水平分为增高组(男性>420umol/L,女性>357umol/L)及正常组(男性≤420umol/L,女性≤357umol/L),分析两组人群的多个代谢性指标的分布特征,并采用logistic回归分析寻找与尿酸相关的危险因素。结果:①两个分组间年龄、收缩压、男性比重、高血压家族史、人体质量指数、腰围、臀围、空腹血糖、肾功能等指标尿酸增高组明显高于尿酸正常组,舒张压则是尿酸增高组明显低于尿酸正常组。②血脂各成分中,总胆固醇、低密度脂蛋白水平尿酸增高组高于正常组,其余甘油三酯、高密度脂蛋白分组间无统计学差异。③尿酸增高组其代谢综合征、高血压、糖尿病、肥胖、腹型肥胖、血脂异常等患病率皆高于尿酸正常组,差异有统计学意义。④Logistic回归分析提示尿酸与你男性性别、年龄、收缩压、BMI、腰围、臀围、空腹血糖、肌酐、总胆固醇、低密度脂蛋白水平呈正相关,与女性性别及舒张压呈负相关。结论:成都地区尿酸与代谢性指标及肾功能相关指标关系密切,可能可以通过减少尿酸来减少心脑血管疾病、代谢性疾病及肾脏疾病的发生。     

有创动脉压监测在危重肝胆手术患者中的应用

目的:探讨有创动脉压监测在危重肝胆手术患者中的应用方法与价值。方法:选择2011年2月到2015年4月在我院进行危重肝胆手术的患者110例,随机分为治疗组与对照组各55例,治疗组在围手术期给予有创动脉压监测,对照组在围手术期给予无创动脉压监测。除所用传感器不一样,均采用监护仪检测患者在围手术期内血压异常、血流动力学参数变化以及并发症发生情况。结果:治疗组围手术期的血压异常率为36.4%,对照组为12.7%,治疗组的血压异常率明显高于对照组(P0.05)。治疗组术中的平均动脉压(MAP)、每搏出量(SV)、每搏指数(SI)、心输出量(CO)和心脏指数(CI)都明显高于对照组(P0.05)。两组围手术期的感染、血肿、神经损伤、皮肤坏死等并发症发生情况对比差异无统计学意义(P0.05)。结论:有创动脉压监测在危重肝胆手术患者中的应用可有效反映血压异常情况,有利于进行心功能的判定,安全性好,有很好的应用价值。     

成都地区中老年居民血清尿酸相关危险因素分析

目的：分析成都地区中老年居民血清尿酸水平及其影响因素,为防治心脑血管事件提供策略支持。方法：利用2007代谢综合征研究调查资料（共1061人）,把人群依据血尿酸水平分为增高组（男性〉420umol/L,女性〉357umol/L）及正常组（男性≤420umol/L,女性≤357umol/L）,分析两组人群的多个代谢性指标的分布特征,并采用logistic回归分析寻找与尿酸相关的危险因素。结果：①两个分组间年龄、收缩压、男性比重、高血压家族史、人体质量指数、腰围、臀围、空腹血糖、肾功能等指标尿酸增高组明显高于尿酸正常组,舒张压则是尿酸增高组明显低于尿酸正常组。②血脂各成分中,总胆固醇、低密度脂蛋白水平尿酸增高组高于正常组,其余甘油三酯、高密度脂蛋白分组间无统计学差异。③尿酸增高组其代谢综合征、高血压、糖尿病、肥胖、腹型肥胖、血脂异常等患病率皆高于尿酸正常组,差异有统计学意义。④Logistic回归分析提示尿酸与你男性性别、年龄、收缩压、BMI、腰围、臀围、空腹血糖、肌酐、总胆固醇、低密度脂蛋白水平呈正相关,与女性性别及舒张压呈负相关。结论：成都地区尿酸与代谢性指标及肾功能相关指标关系密切,可能可以通过减少尿酸来减少心脑血管疾病、代谢性疾病及肾脏疾病的发生。     

老年高血压患者的动态脉压与冠心病并发症及颈动脉粥样硬化的关系研究

目的:探讨老年高血压患者的动态脉压(PP)与冠心病并发症及颈动脉粥样硬化的关系。方法:选取2010年5月至2013年6月在我院就诊的老年性高血压病患者328例,168例单纯性老年高血压患者设为高血压组,160例合并有冠心病的老年性高血压患者设为高血压合并冠心病组。根据厚度(IMT)是否增大将高血压组分为IMT增厚组94例和IMT正常组74例。对动态血压及颈动脉IMT进行测定。结果:与高血压组相比,高血压合并冠心病组的24 hAPP、dPP、nPP等指标以及24 hASBP、nSBP等指标均显著提高;而24hADBP、dDBP、nDBP等指标则明显下降;高血压合并冠心病组24hA PP艹60 mm Hg的发生率为57.50%,明显高于高血压组的39.29%;IMT增厚组患者的24hA PP、dPP及nPP水平均明显高于IMT正常组;艹60 mmHg组共89例,IMT为1.14±0.23 mm,明显高于60 mmHg组79例的平均厚度0.93±0.12 mm(P0.05)。结论:老年高血压患者的动态脉压在冠心病并发症及颈动脉粥样硬化预测方面具有显著的优越性。     

某部机关中老年干部代谢综合征现况调查

目的:了解某部机关中老年干部代谢综合征(Metabolic syndrome,MS)的患病情况,为该类人群疾病的防治提供依据。方法:收集2013年4~5月年在解放军第309医院体检的452例某部机关中老年干部查体资料,按2007年《中国成人血脂异常防治指南》提出的代谢综合征诊断标准进行诊断,分析代谢综合征及代谢指标异常患病情况。结果:受检人群MS患病率11.73%,男性高于女性(P0.05)。年龄组患病率以60~69岁组最高(23.08%)。单项代谢异常检出率从高至低依次为血脂异常(41.15%)、超重和/肥胖(38.5%)、血压升高(25.0%)和血糖升高(9.73%)。不同年龄组代谢指标异常分布情况不同。代谢异常类型以血压升高+血脂升高+超重/肥胖模式人数最多。除MS外,仍有34.52%的人群存在1-2种代谢指标异常。结论:MS可防可控,应注重以胰岛素抵抗(Insulin Resistance,IR)为靶点的多危险因素综合治疗。     

湘西地区农村7-15 岁儿童体重指数、血压及其相关性研究

目的:探讨湘西地区农村7-15岁儿童体重指数、血压及其相关性。方法:随机抽取湘西地区怀化市,吉首市,张家界市农村地区,于2011年1月到3月对7-15岁儿童进行调查。我们采用问卷调查法和体格检查法收集资料,采用中国肥胖问题工作组(WGOC)推荐的"中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准"。高血压诊断采用文献中国儿童青少年血压参照标准评价肥胖和高血压。结果:1755名7-15岁儿童中,男性938人、占53.4%,女性817人占46.6%。男性BMI正常组838人、超重组7人和肥胖组30人,SBP分别为101.1±23.5 mmHg、103.9±12.0 mmHg、106.9±8.8 mmHg,DBP分别为66.7±9.0 mmHg、69.8±7.4 mmHg、71.7±9.1 mmHg。女性BMI正常组768人、超重组43人和肥胖组17人;SBP分别为101.3±35.1 mmHg、104.5±18.0 mmHg、109.1±9.8 mmHg,差异显著,有统计学意义(P<0.05),DBP分别为66.2±8.1 mmHg、71.1±8.8 mmHg、72.0±7.9 mmHg,差异显著,有统计学意义(P<0.05)。制年龄和性别后,BMI与收缩压(SBP)和舒张压(DBP)成独立正相关关系(P<0.05);BMI正常组、超重组和肥胖组的高SBP发生率分别是1.3%、7.1%和15.2%,高DBP发生率分别是4.5%、9.2%和17.4%,高SBP发生率分别是5.3%、13.3%和32.6%,差异显著,有统计学意义(P<0.05)。结论:儿童BMI与SBP和DBP密切相关,儿童超重和肥胖增加高血压的发生风险,且高血压发生率随肥胖程度的增加呈现成倍上升趋势。     

老年肥胖型正常高值血压患者24h-动态血压变异特点及与动脉僵硬度的相关性研究

摘要 目的：探讨老年肥胖型正常高值血压患者24h-动态血压变异特点及与动脉僵硬度的相关性。方法：选择2018年1月~2020年5月期间在我院住院的老年正常高值血压患者174例作为研究对象,根据腰围分为腹型肥胖组（n=85）和非腹型肥胖组（n=89）。所有受试者监测24h-动态血压[包括24h平均收缩压（24h-SBP）、白昼平均舒张压（dDBP）、24h平均舒张压（24h-DBP）、夜间平均收缩压（nSBP）、白昼平均收缩压（dSBP）、夜间平均收缩压（nDBP）、血压变异系数（CV）]和颈-桡动脉脉搏传导速度（crPWV）,分析24h-动态血压变异性、节律性特点和crPWV的影响因素。结果：腹型肥胖组患者非杓型血压、24h-SBP-CV、24h-DBP-CV、dSBP-CV、nSBP-CV、夜间SBP下降率以及crPWV均高于非腹型肥胖组（P<0.05）,腹型肥胖组患者动脉僵硬度增高发生率高于非腹型肥胖组患者（P<0.05）。控制混杂因素后,腹型肥胖组患者腰围与夜间SBP下降率（r=0.338）、24h-SBP-CV（r=0.279）、24h-DBP-CV（r=0.259）、dSBP-CV（r=0.208）、nSBP-CV（r=0.317）、crPWV（r=0.543）呈正相关性（P<0.05）。经多元线性回归分析结果显示,腰围、LDL-C、夜间SBP下降率、24h-SBP-CV和nSBP-CV是crPWV的重要影响因素（P<0.05）。结论：腹部脂肪沉积对老年正常高值血压患者24h动态血压变异性和动脉僵硬度有显著影响,部分24h-动态血压参数与动脉僵硬度有关,控制腰围对预防动脉硬化有着重要的意义。     

The relationship between symptoms of depression and body weight in younger adults

A bidirectional relationship between obesity and depression may exist, though previous results are conflicting. The objectives of our study were to determine whether there is a bidirectional relationship between obesity and symptoms of depression in younger adults and whether this relationship varies with sociodemographic factors. We used data from 7,980 participants in the National Longitudinal Survey of Youth 1979 to examine whether baseline depressive symptoms (score ≥ 10 on a seven-item subscale of the CES-D) in 1992, predicted adjusted percent change in BMI between 1992 and 1994. We then examined whether obesity in 1992 predicted the development of symptoms of depression in 1994, after adjustment for confounders. We found that the presence of baseline depressive symptoms was not prospectively associated with increase in percent BMI, except in Hispanic women. Additionally, baseline obesity was not associated with higher risk of future symptoms of depression in the sample overall (adjusted risk ratio (RR) 1.20; 99% CI 0.91-1.60). However, in those of higher socioeconomic status, obesity was associated with almost double the risk of depressive symptoms compared to nonobese (highest income category: adjusted RR 1.97; 99% CI 1.14-3.40). We concluded that although obesity was not associated with risk of depression symptoms in the population overall, obesity was associated with an increased risk of developing depressive symptoms in those of higher socioeconomic status. Sociodemographic factors may be important modifiers of the relationship between obesity and depression.     

脉搏波传导速度检测在评价高血压病患者大动脉弹性中的应用 与影响因素分析

目的:探讨脉搏波传导速度(PWV)检测在评估高血压病患者大动脉弹性中的应用价值与影响因素分析 方法:采用分层整体抽样法随机抽取高血压病患者2178例,同时抽取非高血压2182人作为对照组.应用Complior SP VP-1000动脉硬化检测仪测定颈一股动脉脉搏波传导速度(C-FPWV)评估大动脉弹性.采用多元逐步线性回归分析性别、年龄、体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、甘油三脂(TG)、空腹血糖(FPG)和尿酸(UA)等指标与高血压痛患者大动脉弹性下降的影响因素.结果:C-FPWV平均值高血压组(1594± 264cm/s)显著高于对照组(1216± 231cm/s),两组差异有显著性意义(X2=31.659,P=0.00).＞40岁各年龄段PWV值上升程度,高血压组明显高于对照组(X2＝ 18.954～36.924,P=0.00),两组PWV值上升程度与年龄呈正相关.多元逐步线性回归分析表明:BMI≥28kg/m2、SBP≥ 140mmHg、DBP≥90mmHg、TC＞5.28± 0.62 mmol/L、TG＞ 1.68± 0.64mmol/L等指标高血压组明显高于对照组(t=14.314～17.428,P＜0.05).在性别、UA和FPG等指标两组无明显差异(X2=6.368～13.618,P＞0.05).结论:高血压痛患者PWV值上升程度显著高于非高血压者,BMI、SBP、TG、TC是高血压病患者大动脉弹性下降的主要影响因素.PWV值可作为评价大动脉弹性的可靠指标.     

The prevalence of pre-hypertension and its association to established cardiovascular risk factors in south of Iran

ABSTRACT: BACKGROUND: Pre-hypertension is associated with an increased risk of the development of hypertension and subsequent cardiovascular disease and raises mortality risk. The aim of this study was to determine the prevalence of pre-hypertension and to explore the associations between pre-hypertension and established cardiovascular risk factors in a population-based sample of Iranian adults. Methods: In this cross-sectional study a representative sample of 892 participants aged [greater than or equal to]30 years was selected using a multistage cluster sampling method. After completion of a detailed demographic and medical questionnaire (gender, age, history of diabetes mellitus and hypertension, taking antihypertensive or hypoglycemic agents and history of smoking), all participants were subjected to physical examination, blood lipid profile, blood glucose, anthropometric and smoking assessments, during the years 2009 and 2010. Variables were considered significant at a p-value [less than or equal to] 0.05. Statistical analysis was performed using SPSS version 11.5 software. RESULTS: Pre-hypertension was observed among 300 (33.7%) subjects, 36.4% for men and 31.4% for women (p > 0.05). The pre-hypertensive group had higher levels of blood glucose and triglycerides, higher body mass index and lower percentage of smoking than did the normotensive group. Multivariate logistic regression analysis showed that obesity and overweight were the strongest predictors of pre-hypertension [odds ratio, 2.74: 95% CI (Confidence Interval), 1.62 to 4.62 p<0.001; odds ratio, 2.56, 95% CI, 1.74 to 3.77, p<0.001 respectively].Conclusions: Overweight and obesity has become important in the association with pre-hypertension in Iranian population. Primary prevention strategies should concentrate on reducing overweight and obesity if the prevalence of pre-hypertension is to be diminished in Iranian adults. Key words: pre-hypertension, cardiovascular risk factor, obesity, BMI.     

The Relation of Body Mass Index,Cardiorespiratory Fitness,and All‐Cause Mortality in Women

Objective: To examine the relation of body mass index (BMI), cardiorespiratory fitness (CRF), and all‐cause mortality in women. Research Methods and Procedures: A cohort of women (42.9 ± 10.4 years) was assessed for CRF, height, and weight. Participants were divided into three BMI categories (normal, overweight, and obese) and three CRF categories (low, moderate, and high). After adjustment for age, smoking, and baseline health status, the relative risk (RR) of all‐cause mortality was determined for each group. Further multivariate analyses were performed to examine the contribution of each predictor (e.g., age, BMI, CRF, smoking status, and baseline health status) on all‐cause mortality while controlling for all other predictors. Results: During follow‐up (113,145 woman‐years), 195 deaths from all causes occurred. Compared with normal weight (RR = 1.0), overweight (RR = 0.92) and obesity (RR = 1.58) did not significantly increase all‐cause mortality risk. Compared with low CRF (RR = 1.0), moderate (RR = 0.48) and high (RR = 0.57) CRF were associated significantly with lower mortality risk (p = 0.002). In multivariate analyses, moderate (RR = 0.49) and high (RR = 0.57) CRF were strongly associated with decreased mortality relative to low CRF (p = 0.003). Compared with normal weight (RR = 1.0), overweight (RR = 0.84) and obesity (RR = 1.21) were not significantly associated with all‐cause mortality. Discussion: Low CRF in women was an important predictor of all‐cause mortality. BMI, as a predictor of all‐cause mortality risk in women, may be misleading unless CRF is also considered.     

Cardiac Autonomic Neuropathy,Estimated Cardiovascular Risk,and Circadian Blood Pressure Pattern in Diabetes Mellitus

This study was designed to investigate potential factors involved in the disruption of the circadian blood pressure (BP) pattern in diabetes mellitus, as well as the relation between BP, cardiac autonomic neuropathy, and estimated cardiovascular risk. We studied 101 diabetic patients (58% with type 2 diabetes; 59% men), age 21–65 yrs, evaluated by 48 h BP monitoring. We performed three autonomic tests in a single session: deep breathing, Valsalva maneuver, and standing up from a seated position. Patients were classified according to the number of abnormal tests and their 10 yr risk of coronary heart disease or stroke. The prevalence of non-dipping 24 h patterning ranged from 47.6% in type 1 to 42.4% in type 2 diabetes. The awake/asleep ratio of systolic BP (SBP) was comparable between patients with or without abnormal autonomic tests. Pulse pressure (PP) was significantly higher in patients with ≥1 abnormal autonomic test (p?<?0.001). Ambulatory SBP was significantly elevated in the group with higher risk of coronary heart disease (p?<?0.001). Patients with higher stroke-risk had higher SBP but lower diastolic BP, and thus an elevated ambulatory PP by 9 mmHg, compared to those with lower risk (p?<?0.001). Cardiac autonomic neuropathy is not the main causal-factor for the non-dipper BP pattern in diabetes mellitus. The most significant finding from this study is the high ambulatory PP found in patients with either cardiac autonomic dysfunction or high risk for coronary heart disease or stroke. After correcting for age, this elevated PP level emerged as the main cardiovascular risk factor in diabetes mellitus.