静息血压控制正常的运动高血压患者临床特征分析及动脉弹性的比较

摘要

Objective To investigate the clinical characteristics and arterial elasticity in hypertensive patients with wel-control ed blood pressure at rest and their response to exercise. Methods Hypertensive patients with wel-control ed blood pressure at rest were divided into two groups according to peak systolic blood pressure(SBP) after sub-maximal treadmil exercise test:hypertensive response group (peak exercise SBP≥200mmHg, n=48) and normal response group (peak exercise SBP<200mmHg, n=53). Cardio-ankle vascular index(CAVI) and blood chemistry were measured in al patients. Results There was significant differences in age, BMI, LDL-C, smoking, stroke, taking statins between two groups (P<0.05). Hypertensive re-sponse group showed higher peak SBP after sub-maximal treadmil exercise test, faster increase of blood pressure than normal response group[(213.73±5.8) vs (177.9±8.4) mmHg and (8.6±1.9) vs (4.9±1.0) mmHg/min, P<0.05]. Patients with hyperten-sive response showed higher CAVI [(10.61±0.78)m/s vs (9.03±0.91)m/s, P<0.05] compared to those with normal response. Sub-maximal exercise systolic blood pressure was correlated with CAVI and taking statins closely (r=0.695 and 0.248,respec-tively, P<0.05). Conclusion Patients with hypertensive response showed higher proportion in CV risk factors and worse arterial elasticity even if their resting blood pressure was control ed wel . Hypertensive response to exercise is associated with CAVI, BMI, HbA1c and whether taking statins closely.%　　目的分析静息血压控制正常的运动高血压患者临床特征及动脉弹性.方法原发性高血压患者101例,根据运动血压结果分为运动高血压组(运动收缩压峰值≥200mmHg,48例)和运动血压正常组(运动收缩压峰值<200 mmHg,53例),用心-踝血管指数(CAVI)作为反映大动脉硬度的指标.结果与运动中血压反应正常组相比,出现运动高血压患者中,老年人、吸烟、肥胖、高HbA1C、高LDL-C、合并脑卒中的比例显著增多,服用他汀类药物比例减少(P<0.05).运动高血压组亚极量运动收缩压、收缩压增量、血压升高速率较运动血压正常组明显偏高,分别为(213.73±5.8)、(177.9±8.4)mmHg,(71.5±6.6)、(44.7±7.6)mmHg,(8.6±1.9)、(4.9±1.0)mmHg/min(均P<0.05)；运动高血压组患者CAVI显著大于运动血压正常组,分别为(10.61±0.78)、(9.03±0.91)m/s (P<0.05).亚极量运动收缩压与CAVI、BMI、HbA1c、是否服用他汀类药物相关(P<0.05或0.01).结论即使静息血压控制正常,出现运动高血压的患者中,心血管危险因素比例显著增多,动脉僵硬度增高.运动血压与动脉弹性、BMI、是否服用他汀类药物、HbA1C密切相关.