LEFT-VENTRICULAR HYPERTROPHY IN PATIENTS WITH HYPERTENSION - IMPORTANCE OF BLOOD-PRESSURE RESPONSE TO REGULARLY RECURRING STRESS
LEFT-VENTRICULAR HYPERTROPHY IN PATIENTS WITH HYPERTENSION - IMPORTANCE OF BLOOD-PRESSURE RESPONSE TO REGULARLY RECURRING STRESS
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DOI：
10.1161/01.cir.68.3.470
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发表时间：
1983-01-01
期刊：
影响因子：
37.8
通讯作者：
LARAGH, JH
中科院分区：
文献类型：
--
作者：
DEVEREUX, RB;PICKERING, TG;LARAGH, JH
左心室肥厚（LVH）是原发性高血压的靶器官反应，与临床血压测量结果仅弱相关。为了确定是否在基础或应激条件下测量的血压更密切地确定左室肥厚，超声心动图左室质量指数和相对壁厚与临床血压和24小时记录（家庭，工作和睡眠）在19名正常人和81例轻度高血压患者进行了比较。在整个研究组中，左心室质量指数与收缩压和舒张压的临床测量值之间只有微弱的相关性（r = 0.24，P < 0.02; r = 0.20，P < 0.05），仅在家中测收缩压和舒张压阅读后略有改善（r = 0.31，P < 0.005; r = 0.21，P < 0.05）。睡眠和24小时总血压与左心室质量指数相关性较差。60例工作时左室质量指数与便携式血压计测得的收缩压和舒张压之间的相关性显著高于对照组（r = 0.50，P < 0.001; r = 0.39，P < 0.01）。工作时舒张压与相对室壁厚度的相关性最好（r = 0.59，P < 0.001）。家庭血压读数在工作日也表现出中度关系与指数的左心室肥厚，而较弱的相关性被发现在就业受试者的血压记录在一个非工作日，血压和左心室肥厚之间没有关系存在于受试者谁没有就业。显然，高血压LVH与临床或家庭血压测量结果的相关性很差，但在工作中反复出现压力时LVH与家庭血压之间以及工作日LVH与家庭血压之间存在更密切的关系。因此，高血压性心脏肥大似乎与压力情况下的血压关系比与基础血压关系更密切。
Left ventricular hypertrophy (LVH), a target organ response in essential hypertension, is only weakly related to clinical measurements of blood pressure. To determine whether blood pressure measured under basal or stress conditions more closely determines LVH, echocardiographic left ventricular mass index and relative wall thickness were compared with clinical blood pressure and with 24 h recordings (home, work and sleep) in 19 normal subjects and 81 patients with mild hypertension. Only a weak correlation was observed in the entire group between left ventricular mass index and clinical measurements of systolic and diastolic blood pressure (r = 0.24, P < 0.02; r = 0.20, P < 0.05, respectively), which was only slightly improved by use of systolic and diastolic blood pressure reading taken in the home (r = 0.31, P < 0.005; r = 0.21, P < 0.05, respectively). Sleep and total 24 h blood pressure related poorly to left ventricular mass index. In contrast, substantially higher correlations existed between left ventricular mass index and systolic and diastolic blood pressure measured by portable recorder in 60 subjects at work (r = 0.50, P < 0.001: r = 0.39, P < 0.01, respectively). Similarly, work diastolic blood pressure bore the closest relationship to relative wall thickness (r = 0.59, P < 0.001). Home blood pressure readings taken on a work day also showed a moderate relationship with indices of LVH, whereas weaker correlations were found in employed subjects whose blood pressure was recorded on a non-workday and no relationship between blood pressure and LVH existed in subjects who were not employed. Apparently, hypertensive LVH is poorly related to clinical or home measurements of blood pressure but that a substantially closer relationship exists between LVH and home blood pressure during recurring stress at work and between LVH and home blood pressure on a workday. Thus hypertensive cardiac hypertrophy appears to be more closely related to blood pressure during stressful situations than to basal blood pressure.