Ambulatory blood pressure, blood pressure variability and the prevalence of carotid artery alteration: the Ohasama study
Ambulatory blood pressure, blood pressure variability and the prevalence of carotid artery alteration: the Ohasama study
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DOI：
10.1097/hjh.0b013e328172dc2e
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发表时间：
2007-08-01
影响因子：
4.9
通讯作者：
Imai, Yutaka
中科院分区：
文献类型：
--
作者：
Shintani, Yoriko;Kikuya, Masahiro;Imai, Yutaka
目的探讨日本普通人群中动态血压（BP）变量（血压水平、短期变异性、昼夜节律变异性和晨起升压峰）与颈动脉改变之间的关系。方法我们对日本普通人群中775名参与者（平均年龄66.2 ± 6.2岁，68.8%为女性）每30分钟测量一次动态血压。白天和夜间的短期BID变异性分别估计为白天和夜间BP的受试者内标准差。昼夜血压变化计算为夜间血压下降的百分比。清晨升压峰定义为清晨血压减去清醒前血压。颈动脉病变程度以颈总动脉内膜中层厚度（IMT）和颈动脉斑块的存在程度作为评价指标。结果白天和夜间血压值与颈动脉病变的相关性高于偶然血压值。通过对白天和夜间血压的相互调整，后者（P < 0.0001）与IMT（代表弥漫性动脉增厚和动脉硬化）的关系比白天血压（P = 0.2）更密切。夜间收缩压变异性与颈动脉斑块（局灶性动脉粥样硬化病变）呈正相关，独立于可能的混杂因素，包括夜间收缩压（P = 0.01）。校正混杂因素后，夜间收缩压下降减少与IMT增大相关（P = 0.03）。结论动态血压水平和血压变异性与颈动脉病变密切相关，提示这些参数是颈动脉病变的独立危险因素或预测因子。
Objectives To investigate the association between ambulatory blood pressure (BP) variables (level, short-term variability, circadian variation and morning pressor surge) and carotid artery alteration in a general population.Methods We measured ambulatory BP every 30 min in 775 participants (mean age 66.2 +/- 6.2 years, 68.8% women) from the Japanese general population. Short-term BID variability during the daytime and night-time were estimated as within-subject standard deviation of daytime and night-time BP, respectively. Circadian BP variation was calculated as the percentage decline in nocturnal BP. Morning pressor surge was defined as morning BP minus pre-waking BP. The extent of carotid artery alteration was evaluated as the average of common carotid intima-media thickness (IMT) and the presence of focal carotid plaque.Results Daytime and night-time BP values were more closely associated with carotid artery alteration than casual BP. With mutual adjustment for daytime and night-time BP, the latter (P < 0.0001) was more closely associated with IMT, which represents diffuse arterial thickening and arteriosclerosis, than daytime BP (P = 0.2). Night-time systolic BP variability was positively associated with carotid plaque (focal atherosclerotic lesions) independently of possible confounding factors, including night-time systolic BP (P = 0.01). A diminished nocturnal decline in systolic BP was associated with a greater IMT after adjustment for confounding factors (P = 0.03). A morning pressor surge was not associated with carotid artery alteration.Conclusion Ambulatory BP levels and BP variability were closely associated with carotid artery alteration, suggesting that these parameters are independent risk factors or predictors of carotid artery alteration.