摘要
目的:探索冷加压试验对远期血压水平的预测价值。方法:采用分层整群抽样法纳入陕西省眉县8个自然村共365人,于2004年进行基线调查并行冷加压试验,2009年及2012年进行2次随访。根据基线个体冷加压试验中收缩压改变的最大值(SR)、收缩压改变的曲线下面积(AUC-SBP)、舒张压改变的最大值(DR)和舒张压改变的曲线下面积(AUC-DBP)按四分位数分别将受试人群分为Ⅰ(P25)组、Ⅱ(P50)组、Ⅲ(P75)组、Ⅳ(P100)组4组,分析个体对冷加压试验的血压反应和随访血压的相关性。结果:(1)无论以SR、DR,还是AUC-SBP、AUC-DBP分组,各组间基线期血压水平、高血压患病率差异均无统计学意义(P>0.05)。(2)以SR分组,从低到高各组2012年高血压患病率为25.64%、30.67%、38.03%、55.74%,组间差异有统计学意义(P<0.01);以AUC-SBP分组,从低到高各组2012年高血压患病率为27.5%、29.17%、38.46%、57.35%,组间差异有统计学意义(P<0.05)。(3)以DR或AUC-DBP分组,2012年各组高血压患病率差异均无统计学意义(P值均>0.05)。(4)随机效应模型分析显示,SR、AUC-SBP与远期收缩压增长幅度的相关系数分别为1.91(P<0.05)、1.44(P<0.05);DR、AUC-DBP与远期舒张压增长幅度的相关系数分别为0.82(P<0.05)、0.78(P>0.05)。年龄、男性、体重指数、空腹血糖均和远期血压的改变成独立正相关,且具有统计学意义(P值均<0.05)。结论:个体对冷加压试验的收缩压反应性可以作为远期高血压发病的预测因素。
Objective The aim of the study was to investigate the correlation between blood pressure response to cold pressor test(CPT)and follow-up blood pressure after 8 years in subjects,and to evaluate the predictive value of CPT for long-term blood pressure levels.Methods A total of 365 individuals from eight natural villages were enrolled by stratified cluster sampling from Mei County,Shaanxi Province in 2004.Baseline characteristics of subjects were collected and CPTs were conducted.Subjects were followed up in 2009 and 2012,respectively.According to the maximal change of systolic response(SR),the area under the curve(AUC)of systolic blood pressure change(AUC-SBP),the maximal change of diastolic response(DR)and the AUC of diastolic blood pressure change(AUC-DBP)in CPT,the individuals were divided into four quartile groups by above parameters,respectively:groupⅠ(P25),groupⅡ(P50),groupⅢ(P75)and groupⅣ(P100).The correlation between blood pressure response to CPT and the follow-up blood pressure was analyzed.Results(1)There were no significant differences in baseline blood pressure levels and prevalence of hypertension among four quartile groups no matter it was grouped on SR,DR,AUC-SBP or AUC-DBP.(2)The prevalence of hypertension in each group from lowest(P25)to highest(P100)in 2012 was 25.64%,30.67%,38.03%,55.74%on SR grouping(P<0.01),and 27.5%,29.17%,38.46%,57.35%on AUC-SBP grouping(P<0.05),respectively.(3)There were no significant differences in the prevalence of hypertension among four groups in 2012(P>0.05)either on DR or on AUC-DBP grouping.(4)The random effects model analysis showed that the correlation coefficient between SR,AUC-SBP and long-term systolic blood pressure increase were 1.91(P<0.05)and 1.44(P<0.05),respectively,and the correlation coefficient between DR,AUC-DBP and long-term diastolic blood pressure increase were 0.82(P<0.05)and 0.78(P>0.05),respectively.Age,male,body mass index,and fasting blood glucose were independent risk factors for long-term blood pressure elevation,and age,body mass index and fasting blood glucose positively correlated with changes in long-term blood pressure(all P<0.05).Conclusion Individual systolic blood pressure response to CPT can be used as a predictor of long-term hypertension.
作者
郭统帅
褚超
郑文玲
胡佳文
牟建军
Guo Tongshuai;Chu Chao;Zheng Wenling;Hu Jiawen;Mu Jianjun(Department of Cardiology,The First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,China)
出处
《中华内科杂志》
CAS
CSCD
北大核心
2020年第4期286-291,共6页
Chinese Journal of Internal Medicine
基金
国家重点研发计划(2016YFC1300100)
国家自然科学基金(81870319)。
关键词
血压
冷加压试验
高血压
应激
Blood pressure
Cold pressor test
Stress
Hypertension
作者简介
通信作者:牟建军,Email:mujjun@163.com。
