ObjectiveTo investigate the relationship of 24-hour ambulatory pulse pressure (24hPP) with left ventricular mass index (LVMI) in elderly essential hypertension patients. MethodsThe data of 110 elderly patients with essential hypertension from January to December 2012 were collected in the study. All patients received 24-hour ambulatory blood pressure monitoring and echoeardiographic examination 24hPP and LVMI were calculated according to the results of 24-hour ambulatory blood pressure monitoring and echocardiographic measurements. The patients were divided into group A [24hPP<60 mm Hg (1 mm Hg=0.133 kPa), n=70] and group B (24hPP≥60 mm Hg, n=40). ResultsThe 24-hour systolic blood pressure and 24hPP for patients in group B were significantly higher than those in group A (P<0.001). Compared with group A patients, the interventricular septal thickness, left ventricular posterior wall thickness, left ventricular mass and left ventricular mass index were significantly higher in group B (P<0.05). Pearson correlation analysis showed that 24hPP had a positive correlation with LVMI in the elderly essential hypertension patients (r=0.33, P<0.001). Multiple stepwise regression analysis showed that 24hPP was the main factor for the increase of LVMI in elderly essential hypertension patients (β=0.90, P<0.001). ConclusionThe 24hPP is positively correlated with LVMI in elderly essential hypertension patients. The 24hPP is an important risk factor for left ventricular structural damage in elderly essential hypertensive patients.
Non-drug treatment of hypertension has become a research hotspot, which might overcome the heavy economic burden and side effects of drug treatment for the patients. Because of the good treatment effect and convenient operation, a new treatment based on slow breathing training is increasingly becoming a kind of physical therapy for hypertension. This paper explains the principle of hypertension treatment based on slow breathing training method, and introduces the overall structure of the portable blood pressure controlling instrument, including breathing detection circuit, the core control module, audio module, memory module and man-machine interaction module. We give a brief introduction to the instrument and the software in this paper. The prototype testing results showed that the treatment had a significant effect on controlling the blood pressure.
目的:应用应变率探讨不同左心室构型的原发性高血压患者左心室长轴方向应变－应变率成像的变化,及其与EF、FS及二尖瓣血流测量评价左室功能的对照研究。方法:采用M型、二维、多普勒超声及应变率成像技术,测量左室室壁厚度、左室内径、EF、FS,二尖瓣血流频谱E、A及左室平均应变ε,应变率S、e、a。结果:高血压离心性肥厚组EF、FS明显低于对照组,高血压其余各组EF、FS与对照组无统计学差异;收缩期应变率S应变ε在五组间差异均有显著性意义:高血压各组较正常对照组减小(I--Ⅴ呈递减);舒张期应变率e减低、a增高,e/a比值减小,各组间存在统计学差异(Plt;0.05); E/A,e/a结果大体一致。结论:应变率成像为临床提供了一个敏感、简便、可靠的评价原发性高血压患者左室心肌功能的指标。
Objective To investingate the ultrastructural changes of retinal pigment epithelium(RPE) and its permeability in spontaneously hypertensive rats(SHR)and explore the relation between these changes and hypertensive retinopathy.MethodsThe ultrastructure of RPE cells in the SHR aged five,six,seven months wasobserved with transmission electronmicroscope and compared to its normotensive control strain(WKY) with the same age.Then,lanthanum tracer procedures were carried out to investigate pathological changes of the blood-retinal barrier.Results (1)In SHR the main pathological changes involved swelling of mitochondria,enlargement of endoplasmic reticula,decrease of RPE cell infolding,and sparseness of microvilli.These degenerations were more serious in older rats with higher blood pressure.(2)The breakdown of outer blood-retinal barrier with permeation of lanthanum tracers were evident in SHR aged six or seven month,however,in WKY and five-month SHR the traces were prevented from passing by tight junctions.ConclusionThe degeneration of RPE owing to ischemia and anoxia arises in early periosd of hypertensive retinopathy.The pathological changes of ultrastructure and permeability might interact with the damage of visual cells and play a main role in the hypertensive retinopathy.
ObjectiveTo investigate the use of anti-hypertensive drugs among hypertension patients in examination medical center. MethodThis was a cross-sectional survey. Data of 3 000 cases of medical examination center health records from December 2012 to December 2013 were sampled, and 1 310 patients with hypertension were screened for analysis of medication. ResultsIn the 1 310 hypertension patients, 959 used antihypertensive drugs before, among whom 423 (44.11%) accepted only one anti-hypertensive drug and 536 (55.89%) accepted compound anti-hypertensive drugs or combined medicine. In patients of the previous kind, calcium channel blocker classes of antihypertensive drugs were used the most (n=244, 25.44%). Among the second kind of patients, 359 (37.43%) were treated with a two-compound drug or a combination of two drugs, and most of them used the combination of calcium channel blocker with angiotensin receptor blocker or calcium channel blocker with angiotensin converting enzyme inhibitor. ConclusionsThe current using of anti-hypertensive drug is in accordance with the recommendation of anti-hypertensive treatment guidelines in some way, but there are still some gaps between real clinical practice and guidelines.
ObjectiveTo systematically review the association between insomnia and the risk of hypertension. MethodsThe EMbase, PubMed, The Cochrane Library, VIP, WanFang Data and CNKI databases were electronically searched to collect cohort studies on the association between insomnia and hypertension from inception to October 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 13.0 software. ResultsA total of 20 cohort studies involving 607 409 participants were included. The results of meta-analysis showed that insomnia increased the risk of hypertension (RR=1.24, 95%CI 1.15 to 1.34, P<0.000 1). Subgroup analysis showed that insomnia increased the risk of hypertension in North American, European and Oceanian population, but not in Asian population. The difficulty falling asleep, difficulty maintaining sleep and early awakening all increased the risk of hypertension. ConclusionCurrent evidence suggests that insomnia increases the risk of hypertension.
目的 明确异丙酚对于高血压脑出血患者血清炎性细胞因子的影响。 方法 将2008年3月-2009年3月收治的高血压脑出血患者47例分为两组，异丙酚组采用异丙酚、芬太尼、维库溴铵以及异氟醚诱导和维持麻醉；对照组采用依托咪酯、芬太尼、维库溴铵以及异氟醚诱导和维持麻醉。比较两组患者手术中不同时段血清白细胞介素（IL-6）、肿瘤坏死因子（TNF）、血栓素、内皮素、前列腺素E和降钙素水平。 结果 患者麻醉过程中生命体征平稳，无麻醉相关死亡。术前异丙酚组患者血清IL-6、TNF、血栓素、内皮素、前列腺素E和降钙素水平与对照组比较均无差异(P＞0.05)，而麻醉诱导后差异有统计学意义(P＜0.05)，而且差异随时间延长增大。 结论 采用异丙酚麻醉能降低术中血清炎性细胞因子水平。
Objective To explore and compare the diagnostic value of blood pressure, brain natriuretic peptide (BNP), pulmonary artery systolic pressure (PASP) in evaluating right ventricular dysfunction (RVD) in patients with acute pulmonary embolism (APE). Methods A retrospective study was conducted on 84 APE patients who were diagnosed by computed tomographic pulmonary angiography. The patients were divided into a RVD group and a non-RVD group by echocardiography. Eighteen clinical and auxiliary examination variables were used as the research factors and RVD as the related factor. The relationship between these research factors and RVD were evaluated by logistic regression model, the diagnostic value of BNP and PASP to predict RVD was analyzed by receiver-operating characteristic (ROC) curve analysis. Results The patients with RVD had more rapid heart rate, higher diastolic blood pressure, higher mean arterial pressure, higher incidence of BNP>100 pg/ml and higher incidence of PASP>40 mm Hg (allP<0 05="" upon="" logistic="" regression="" model="" bnp="">100 pg/ml (OR=4.904, 95%CI 1.431–16.806, P=0.011) and PASP>40 mm Hg (OR=6.415, 95%CI 1.509–27.261, P=0.012) were independent predictors of RVD. The areas under the ROC curve to predict RVD were 0.823 (95%CI 0.729–0.917) for BNP, and 0.798 (95%CI 0.700–0.896) for PASP. Conclusions Blood pressure related parameters can not serve as a predictor of RVD. Combined monitoring of BNP level and PASP is helpful for accurate prediction of RVD in patients with APE.
Objective To analyze the causes of missed diagnosis of sleep apnea hypopnea syndrome ( SAHS) . Methods 42 missed diagnosed cases with SAHS from May 2009 to May 2011 were retrospectively analyzed and related literatures were reviewed. Results The SAHS patients often visited the doctors for complications of SAHS such as hypertension, diabetes mellitus, metabolic syndrome, etc. Clinical misdiagnosis rate was very high. Lack of specific symptoms during the day, complicated morbidities, and insufficient knowledge of SAHS led to the high misdiagnosis rate and the poor treatment effect of patients with SAHS. Conclusion Strengthening the educational propaganda of SAHS, detail medical history collection, and polysomnography monitoring ( PSG) as early as possible can help diagnose SAHS more accurately and reduce missed diagnosis.