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題 名 | Prevalence of "Non-Dippers" Increased with Severity of Hypertension=隨高血壓嚴重程度而增加之「夜間血壓不降」之盛行率 |
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作 者 | 董俊伯; 黃耀星; 顏學偉; 林慶正; | 書刊名 | Acta Cardiologica Sinica |
卷 期 | 13:3 民86.07-09 |
頁 次 | 頁123-128 |
分類號 | 415.382 |
關鍵詞 | 夜間血壓不降; 夜間血壓下降; 可移種性血壓監測器; Dippers; Non-dippers; Ambulatory blood pressure monitoring; |
語 文 | 英文(English) |
中文摘要 | 背景:根據以往的研究,一個人的血壓在晚上睡覺時會降低,而早上起床時會上升,高血壓的病患若無此變化,則其未來發生心臟血管病變之機會將增加,本研究的目的是探討血壓早高晚低之現象消失的發生率與高血壓之嚴重度間是否有關。 方法:我們回溯107個正常血壓及313個未經治療之高血壓病人的24小時血壓記錄,分析其24小時平均血壓,清醒時及睡眠時之血壓,和睡眠時血壓下降之百分比,若此百分比小於10%,定義為“non-dipper”。高血壓之分類採用JNC-V分類而24小時血壓記錄採用Spacelab 90202及90207 model。 結果:107個血壓正常者其平均血壓127 ± 8/80 ± 7 mmHg,non-dippers發生率39%。146個第一度,48個第二度,19個第三度和第四度高血壓病人其平均血壓分別是146 ± 8/92 ± 5 mmHg,155 ± 9/104 ± 4 mmHg,178 ± 15/l12 ± 7 mmHg,而non-dippers發生率分別是47%,58%,74%。 結論:整個高血壓病患non-dippers的發生率是52%,且隨著高血壓嚴重度增加,non-dippers之發生率也增加。由本研究我們建議要評估高血壓患者non-dippers之發生率,其白天及晚上之血壓應以清醒及睡眠的時間來區分,而不要以事先設定的時段來區分。 |
英文摘要 | Background. Previous studies have demonstrated that blunted nocturnal fall in blood pressure (BP) in hypertension patients predicted future cardiovascular events. This study aim was to determine whether the prevalence of nocturnal dipping of BP is related to the severity of hypertension. Methods. Retrospective analysis of 24-hour ambulatory BP (ABP) recordings of 320 patients was undertaken; 107 normotensive controls and 213 untreated hypertensive patients were targeted. The 24-hr ABP recordings were analyzed in all patients to assess mean 24-hr BP, awake and asleep BP, percentage of nocturnal fall of mean systolic and diastolic BP (%NFSBP & %NFDBP). "Non-dipper" was arbitrarily defined by NFSBP and NFDBP <10% of daytime BP. Patients were asked to recorded activity in a diary, with particular attention to noting sleeping time at night and waking time in the morning. Recalculation of day-time and nighttime BP was done according to awake and asleep period recorded by patients. Severity of hypertension was classified by new staging criteria provided by JNC-V reports. Results. Of the 320 patients, the mean BP of the normotensive controls was 127 ± 8/80 ± 7 mmHg; the non-dippers frequency was 39%. There were 146 stage I, 48 stage II and 19 stage III + IV hypertensive patients, whose mean HPs were 146 ± 8/92 ± 5 mmHg, 155 ± 9 I 104 ± 4 mmHg, and 178 ± 15/112 ± 7 mmHg, respectively. The non-dippers frequency was 47%, 58%, and 74%, respectively (P<0.05). In this study, the overall non-dippers prevalence was 52%. Conclusion. In this hypertension population, 52% of the patients was non-dippers. The non-dipper frequency was significantly increased with increased severity of hypertension. In dippers, the magnitude of nocturnal fall in blood pressure was similar in the four stages of hypertension. In evaluating the prevalence of non-dippers hypertension, it would be more appropriate to define day-time and night-time according to awake and asleep periods, rather than using predetermined limits. |
本系統中英文摘要資訊取自各篇刊載內容。