The association of borderline hypertension with target organ changes and higher coronary risk. Tecumseh Blood Pressure study.
The association of borderline hypertension with target organ changes and higher coronary risk. Tecumseh Blood Pressure study.
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DOI：
10.1001/jama.1990.03450030078036
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发表时间：
1990-07
期刊：
影响因子：
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通讯作者：
S. Julius;K. Jamerson;A. Mejia;L. Krause;N. Schork;Kerin Jones
中科院分区：
文献类型：
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作者：
S. Julius;K. Jamerson;A. Mejia;L. Krause;N. Schork;Kerin Jones
Tecumseh 项目调查健康人群中高血压的演变。在 946 名年龄在 18 岁至 38 岁之间的受试者中，有 124 名临床血压读数高于 140/90 mm Hg（临界高血压受试者的平均值为 130/94 mm Hg）。与血压正常的受试者相比，临界高血压受试者的家庭血压较高（平均高出 12/7 mm Hg）。他们的儿童期和青春期后血压升高（6岁时比正常值高6/4毫米汞柱，21岁时比正常值高12/7毫米汞柱），并检测到高血压靶器官变化。临界高血压受试者的最小前臂阻力也升高（比正常值高 0.22 U），卒中指数降低（比正常值低 1.8 mL/m2），心室舒张期舒张受损（二尖瓣舒张早期峰值血流 [E] 与舒张晚期峰值血流 [A] 的比率比正常值低 0.13）。临界高血压受试者的其他冠脉危险因素也有显着异常（胆固醇水平升高0.39 mmol/L，甘油三酯水平升高0.45 mmol/L，高密度脂蛋白水平降低0.08 mmol/L，胰岛素水平升高38 pmol/L，其中超重的比例增加16.5%）。临界高血压既不是暂时性的，也不是无害的。它与动脉粥样硬化的其他预测因子的关联需要临床关注。
The Tecumseh project investigates the evolution of hypertension in a healthy population. Of 946 subjects aged 18 through 38 years, 124 had clinic blood pressure readings higher than 140/90 mm Hg (the mean for borderline hypertensive subjects was 130/94 mm Hg). Compared with normotensive subjects, borderline hypertensive subjects had higher home blood pressures (mean, 12/7 mm Hg higher). Their childhood and postpubertal blood pressures were elevated (6/4 mm Hg higher than normal at age 6 years and 12/7 mm Hg higher than normal at age 21 years), and hypertensive target organ changes were detected. Borderline hypertensive subjects also had elevated minimal forearm resistance (0.22 U higher than normal), decreased stroke index (1.8 mL/m2 lower than normal), and impaired ventricular diastolic relaxation (mitral Doppler peak early diastolic blood flow [E] to peak late diastolic blood flow [A] ratio 0.13 lower than normal). Borderline hypertensive subjects had significant abnormalities in other coronary risk factors (cholesterol levels were 0.39 mmol/L higher, triglyceride levels were 0.45 mmol/L higher, high-density lipoprotein levels were 0.08 mmol/L lower, insulin levels were 38 pmol/L higher, and 16.5% more of them were overweight). Borderline hypertension is neither transient nor innocuous. Its association with other predictors of atherosclerosis calls for clinical attention.