Relationship between initial cardiovascular structural changes and daytime and nighttime blood pressure monitoring.
Relationship between initial cardiovascular structural changes and daytime and nighttime blood pressure monitoring.
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初始心血管结构变化与日间和夜间血压监测之间的关系。
DOI：
10.1093/ajh/5.3.180
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发表时间：
1992
影响因子：
3.2
通讯作者：
E. Agabiti
中科院分区：
文献类型：
--
作者：
D. Rizzoni;M. Muiesan;Giovanni Montani;R. Zulli;S. Calebich;E. Agabiti
已经表明，在高血压患者中，靶器官损害的程度与24小时动态监测（ABPM）记录的平均血压比与门诊血压更密切相关。我们对91名临床健康者、23名正常血压者和68名高血压者进行了临床血压检查。通过超声心动图研究心脏解剖。作为动脉结构变化的指标，根据平均动脉压和最大缺血后血流量计算前臂最小血管阻力，如通过静脉闭塞体积描记法评估的。结果与门诊血压或ABPM值（通过无创ABPM ICR 5200，Spacians，Bellevue，CA测量）相关。左心室质量与24小时内或白天或夜间记录的平均血压的相关性比与门诊血压的相关性更密切。最小血管阻力也与ABPM值显著相关，但相关性与临床血压相似。最小血管阻力与血压变异性显著相关，通过平均值的标准差进行评价。在夜间血压没有显著降低的患者亚组中，最小血管阻力和左心室质量较高。本研究的结果证实，平均ABPM值升高与较高的左心室质量相关;此外，它们表明血压变异性增加可能与血管结构变化相关，如通过最小血管阻力评估的。心脏肥大和/或血管结构变化是否是血压值和变异性增加的原因或结果仍有待澄清。
It has been shown that in hypertensive patients the degree of target organ damage correlates more closely with average blood pressure as recorded by ambulatory monitoring (ABPM) throughout 24 h than with clinic blood pressure. We examined a group of 91 clinically healthy subjects, 23 normotensives and 68 hypertensives according to clinic blood pressure. Cardiac anatomy was investigated by echocardiography. As an index of arterial structural changes forearm minimal vascular resistance was calculated from mean arterial pressure and maximal postischemic blood flow, as assessed by venous occlusion plethysmography. The results were correlated to clinic blood pressure or ABPM values (measured by noninvasive ABPM ICR 5200, Spacelabs, Bellevue, CA). Left ventricular mass was correlated more closely with the average blood pressure recorded during 24 h, or during daytime or nighttime periods, than with clinic blood pressure. Minimal vascular resistance was also significantly correlated to ABPM values, but the correlation was similar to that observed with clinic blood pressure. Minimal vascular resistance was significantly correlated to blood pressure variability, as evaluated by the standard deviation of the mean. Minimal vascular resistance and left ventricular mass were higher in a subgroup of patients in whom blood pressure was not significantly reduced during the night. The results of this study confirm that elevated average ABPM values are associated to higher left ventricular mass; in addition, they suggest that increased blood pressure variability may be associated with vascular structural changes, as evaluated by minimal vascular resistance. It remains to be clarified whether cardiac hypertrophy and/or vascular structural changes are a cause or consequence of increased blood pressure values and variability.