The Impact of Obesity on Nighttime Blood Pressure Dipping.
The Impact of Obesity on Nighttime Blood Pressure Dipping.
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DOI：
10.3390/medicina56120700
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发表时间：
2020-12-15
期刊：
影响因子：
--
通讯作者：
Gromadziński L
中科院分区：
文献类型：
--
作者：
Moczulska B;Zechowicz M;Leśniewska S;Osowiecka K;Gromadziński L
背景与目的：众所周知，肥胖不仅会增加动脉高血压（HT）的风险，而且会影响抗高血压药物的疗效。本研究旨在评估基于动态血压测量（ABPM）的肥胖患者血压（BP）参数。材料与方法：研究组纳入128例肥胖（BMI≥30 kg/m2）患者，平均年龄43.25岁（±12.42岁），其中男性55例，女性73例。患者分为BMI≥30 kg/m2和<40 kg/m2两组，BMI≥40 kg/m2两组。每例患者进行24小时血压监测。测量24小时、白天和夜间的平均收缩压和舒张压，以及24小时平均心率和夜间下降百分比。结果：组1平均BMI为34.73 kg/m2（±2.96），组2平均BMI为47.6 kg/m2（±6.3）。1组患者年龄明显大于2组（46.5 vs 39）。ABPM分析显示，2组所有测量值的血压值均显著升高(即收缩压（SBP） 24 h中位数= 132 mmHg；舒张压（DBP） 24 h中位数= 84 mmHg。第1组夜间下降幅度较大（8.95%）。2组患者24小时平均心率（76次/分）高于1组（67.5次/分）。2组中超过一半的患者曾接受过HT治疗，根据ABPM， 1组中有6例患者被诊断为新HT， 2组中有14例患者被诊断为新HT。根据夜间的蘸水情况，将患者分为三组：蘸水者、不蘸水者和反蘸水者。未发现极端勺型患者。第2组有更多的反向倾斜型患者。结论：极端病态肥胖患者常表现为反倾型HT。这种类型通常与更严重的心血管疾病的高风险有关。
Background and objectives: It is commonly known that obesity not only increases arterial hypertension (HT) risk but also impacts on the response to antihypertensives. This study aimed to assess blood pressure (BP) parameters based on Ambulatory Blood Pressure Measurement (ABPM) in obese patients. Materials and Methods: The study group consisted of 128 patients with obesity (BMI ≥ 30 kg/m2), with an average age of 43.25 years (±12.42), including 55 males and 73 females. They were divided into 2 groups: 1-with BMI ≥ 30 kg/m2 and <40 kg/m2, 2-with BMI ≥ 40 kg/m2. Each patient underwent 24-h blood pressure monitoring. The average 24-h, daytime and nighttime systolic and diastolic pressure, as well as 24-h mean heart rate and % of nocturnal dip, were assessed. Results: Mean BMI in group 1 was 34.73 kg/m2 (±2.96), and in group 2 it was 47.6 kg/m2 (±6.3). Group 1 was significantly older than group 2 (46.5 vs. 39 years old). The analysis of ABPM revealed significantly higher BP values in all measurements in group 2 (i.e., systolic blood pressure (SBP) 24 h median = 132 mmHg; diastolic blood pressure (DBP) 24 h median = 84 mmHg). The nocturnal dip was greater in group 1 (8.95%). Mean 24-h heart rate was also higher in group 2 (median = 76 beats/min) than group 1 (median = 67.5 beats/min). More than half of patients in group 2 had been previously treated for HT, and based on ABPM, new HT was diagnosed in 6 patients from group 1 and 14 patients from group 2. Three groups of patients were identified based on nighttime dip: dipper, non-dipper, and reverse-dipper. No patient of the extreme dipper type was found. Group 2 comprised of significantly more patients of the reverse-dipper type. Conclusions: Patients with extreme morbid obesity frequently exhibit HT of the reverse-dipping pattern. This type is often linked with a higher risk of more advanced cardiovascular illness.
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影响因子：
4.5
作者：
Kim, Bae Keun;Kim, Yu-Mi;Shin, Jinho
通讯作者：
Shin, Jinho
影响因子：
2.9
作者：
Kim BK;Lim YH;Lee HT;Lee JU;Kim KS;Kim SG;Kim JH;Lim HK;Shin J
通讯作者：
Shin J
影响因子：
4.9
作者：
Kelly, T.;Yang, W.;He, J.
通讯作者：
He, J.
DOI：
10.1016/s0140-6736(10)62037-5
发表时间：
2011-02-12
期刊：
Lancet (London, England)
影响因子：
--
作者：
Finucane MM;Stevens GA;Cowan MJ;Danaei G;Lin JK;Paciorek CJ;Singh GM;Gutierrez HR;Lu Y;Bahalim AN;Farzadfar F;Riley LM;Ezzati M;Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Body Mass Index)
通讯作者：
Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Body Mass Index)
影响因子：
168.9
作者：
Swinburn, Boyd A.;Sacks, Gary;Gortmaker, Steven L.
通讯作者：
Gortmaker, Steven L.