Objective: To explore the relationship between blood pressure variability (BPV) and combined cardiovascular events in 5-10 years in patients with hypertension.
Methods: A total of 367 hypertensive patients treated in our hospital from January, 2000 to January, 2005 were analyzed, and their BPV was assessed in comparison with 145 normotensive individuals. The hypertensive patients were classified into high BPV group and low BPV group, and the general clinical data and biochemical profiles were compared. The relationship between BPV and combined cardiovascular events of the patients within 5-10 years were explored.
Results: Compared with the normotensive individuals, the hypertensive patients showed significantly increased standard deviation and coefficient of variation of 24-h systolic blood pressure (SBP), 24-h diastolic blood pressrue (DBP), daytime SBP, daytime DBP, night-time SBP and night-time DBP (P<0.01). The percentages of drinking, smoking, diabetes and coronary heart disease were significantly higher in patients with high BPV than those with lower BPV (P<0.01 or 0.05); uric acid, homocysteine, urinary protein/creatinine ratio and urinary microalbumin increased more significantly in patients with high BPV (P<0.01 or 0.05). In addition, the combined cardiovascular events in 5-10 years were significantly higher in the patients with higher BPV than those with lower BPV (P<0.01 or 0.05). Logistic multivariate logistic regression analysis showed that alcohol, diabetes, coronary heart disease, uric acid and homocysteine were independent risk factors for cardiovascular events in hypertensive patients (P<0.01 or 0.05).
Conclusion: In hypertensive patients, BPV is closely correlated with the long-term combined cardiovascular events, and a high BPV is associated with a greater likeliness of combined cardiovascular events.
目的: 探究高血压患者血压变异性（BPV）与患者5~10年复合心血管事件的关系。
方法: 回顾性分析本院于2000年1月~2005年1月收治的367例住院治疗的高血压患者，检测BPV，然后根据患者的BPV对其分组，分为高BPV高血压组（166例）和低BPV高血压组（201例），再检测两组患者的一般临床资料和生化指标，分析BPV与高血压患者复合心血管事件的关系以及影响复合心血管事件的因素。
结果: 与正常人群相比，高血压患者的24 h平均收缩压（24 h SBP）、24 h平均舒张压（24 h DBP）、白天平均收缩压（d SBP）、夜间平均收缩压（n SBP）、白天平均舒张压（d DBP）和夜间平均舒张压（n DBP）的标准差和变异系数均明显升高，差异具有统计学意义（P < 0.01）。与BPV较低的高血压患者相比，BPV较高的患者中，饮酒比例、吸烟比例、糖尿病比例和冠心病史比例显著增加，差异具有统计学意义（P < 0.05或P < 0.01）；生化指标的变化趋势与上述指标相似，其中尿素氮、尿酸、同型半胱氨酸、尿蛋白/肌酐比值和尿微量白蛋白增加的更加明显，差异也具有统计学意义（P < 0.05）。另外，与BPV较低的高血压患者相比，BPV较高的高血压患者的5年、10年复合心血管事件发生率明显增加，差异具有统计学意义（P < 0.05）。进一步采用Logistic多因素回归分析表明，饮酒、糖尿病、冠心病史、尿酸和同型半胱氨酸是高血压患者发生心血管事件的独立危险因素（P < 0.05）。
结论: 高血压患者的BPV与患者的长期复合心血管事件之间有密切的关系，其中高BPV的高血压患者更易发生复合心血管事件。