Usefulness of circadian amplitude of blood pressure in predicting hypertensive cardiac involvement.
Usefulness of circadian amplitude of blood pressure in predicting hypertensive cardiac involvement.
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血压的昼夜振幅在预测高血压心脏受累中的有用性。
DOI：
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发表时间：
1992
期刊：
影响因子：
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通讯作者：
F. Halberg
中科院分区：
文献类型：
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作者：
Y. Kumagai;T. Shiga;K. Sunaga;G. Cornelissen;A. Ebihara;F. Halberg
采用单余弦法拟合24小时余弦曲线，对56例WHO诊断为高血压患者的24小时血压曲线进行分析。左心室质量指数（LVMI）也通过二维超声心动图评估每例患者的靶器官受累程度。LVMI和BP MESOR与收缩压、S（r = 0.324），平均动脉，MA（r = 0.334）与舒张期D（r = 0.267）BP（P <0.05），但LVMI与昼夜血压幅度之间无统计学显著线性相关性当对昼夜血压幅度进行二次多项式回归时，（SBP：R2 = 0.138，P = 0.02; MAP：R2 = 0.167，P = 0.01; DBP：R2 = 0.128，P <0.01）。相应的曲线的特点是峰值的收缩压，平均动脉压和舒张压的昼夜节律幅度的LVMI值之间的110和120 g/m2。为了进一步审查，根据文献，就LVMI先验地形成了三个分组（第1组：LVMI小于100;第2组：LVMI小于130;第3组：LVMI小于130）。对于MESOR，第1组和第2组之间没有差异，而第3组的MESOR大于其他两组。组2的收缩压、平均动脉压和舒张压的昼夜节律幅度大于其他两组。LVMI的增加先于BP MESOR的确定性增加，并且与昼夜血压幅度的增加一致;因此，昼夜变化程度的增加可以提醒自我监测人群靶器官受累。
Twenty-four-hour blood pressure (BP) profiles of 56 patients diagnosed as 'hypertensive' by WHO criteria were analyzed by the fit of a 24-hour cosine curve according to the single cosinor method. A left ventricular mass index (LVMI) was also assessed by two-dimensional echocardiography on each patient as a gauge of target organ involvement. LVMI and the BP MESOR correlates positively for systolic, S (r = 0.324), mean arterial, MA (r = 0.334) and diastolic, D (r = 0.267) BP (P less than 0.05), yet no statistically significant linear correlation between LVMI and the circadian BP amplitude (one-half of predictable change) was found. When a second-degree polynomial regression was fitted to the circadian BP amplitudes, an association was found (SBP: R2 = 0.138, P = 0.02; MAP: R2 = 0.167, P = 0.01; DBP: R2 = 0.128, P less than 0.01). The corresponding curves were characterized by peaks in the circadian amplitudes of SBP, MAP and DBP around a value of LVMI between 110 and 120 g/m2. For further scrutiny, three subgroups had been formed on the basis of literature, a priori with respect to the LVMI (group 1: LVMI less than 100); group 2: 100 less than LVMI less than 130; group 3: 130 less than LVMI). For MESORs, there was no difference between groups 1 and 2, whereas the MESOR of group 3 were larger than the other two groups. The circadian BP amplitudes of group 2 were larger than those of the other two groups for SBP, MAP and DBP. An increasing LVMI precedes a definitive increase of BP MESOR and coincides with an increase in the circadian BP amplitude; thus an increase in extent of circadian changes can alert the self-monitoring population of a target organ involvement.