不同体质指数对盐负荷及补钾的血压反应研究

目的探讨不同体质指数(BMI)受试者对盐负荷及补钾的血压反应。方法在陕西眉县农村选择年龄在16-60岁的农民39例,血压正常或轻度偏高的自愿者进行为期三周的慢性盐负荷及补钾试验,包括基线3天、低盐、高盐、补钾各7天的研究。各个阶段测量身高、体重及血压。结果与BMI30kg/m2者相比,BMI≥30kg/m2者有较高的基线血压,限盐饮食后血压下降幅度更大,高盐饮食后血压升高幅度大,补钾后的血压下降幅度也大。结论体质指数不仅与高血压相关,可能也参与了盐敏感性的发生与发展。补钾对于高体质指数者降压效果更明显。     

济南市城区年龄6～17岁儿童青少年血压偏高现状

目的探讨济南市城区年龄6~17岁儿童青少年血压偏高现状。方法数据来源于2012年9月至2014年9月进行的十二五国家科技支撑计划课题"儿童心血管疾病的预警、诊治技术研究"济南调查点。本研究共纳入济南市城区年龄6~17岁儿童青少年7840人,其中男生占52.1%。利用国内外3种儿童青少年高血压诊断标准,估算济南市城区年龄6~17岁儿童青少年血压偏高检出率,并采用Cochran-Armitage趋势检验评估血压偏高检出率的变化趋势。结果依据中国、美国和国际标准,济南市城区年龄6~17岁儿童青少年血压偏高检出率分别为17.2%、9.4%和15.0%;男生分别为20.5%、12.1%和19.2%;女生分别为13.5%、6.4%和10.4%。与年龄6~11岁儿童血压偏高检出率比较,年龄12~17岁青少年血压偏高检出率随年龄变化的增加趋势更加明显。结论济南市城区年龄6~17岁儿童青少年血压偏高检出率较高,尤其在12岁之后随年龄增加迅速。     

原发性高血压患者血压变异性的临床研究

目的　探讨原发性高血压 (EH )患者血压变异性与靶器官损害、血压增高的程度及年龄的关系。方法　对65例EH患者及 40例正常人 (对照组 )进行 2 4h动态血压监测 ,以测定的血压标准差作为血压变异性指标。结果　EH组血压变异性明显大于对照组 ,Ⅱ、Ⅲ期EH患者血压变异性明显大于Ⅰ期EH患者 ;EH患者血压变异性随血压水平的增加而逐渐增大 ,年龄≤ 5 5岁者 ,其血压变异性随年龄的增加而增大 ,年龄 >5 5岁者 ,其血压变异性不再随继续增加。结论　EH患者血压变异性明显增加 ,且靶器官损害越重 ,血压值越高 ,在一定范围内年龄越大则血压变异性越大     

14041例体检职工血压水平分析

目的:了解2010-03-2011-09某单位体检人群血压水平分布,分析影响人群血压水平、高血压流行的相关危险因素,为防治人群高血压和控制其危险因素提供科学依据。方法:安排在职职工和离退休职工进行体检,符合本次研究要求且资料完整者14 041人。体检内容包含体格检查和相关实验室检测,无问卷调查资料。采用专用体检记录电脑软件录入体检者资料,体检全部结束后导出数据,用SPSS分析软件分析血压水平的分布特征及相关因素。结果:体检人群达高血压水平者35.76%。血压水平、高血压患病率、血压分级水平差异具有统计学意义。30岁以后舒张压随年龄增长而升高,但60岁以后随年龄增长而下降;40岁以后收缩压随年龄增长而升高,50岁以后脉压差随年龄增长而升高。人群血压水平、高血压比例随体重的增加而升高,肥胖者高血压达62.3%。多因素分析示,血压水平与年龄、BMI、空腹血糖(FPG)、血清尿酸(UA)、TC、TG、LDL正相关,与HDL、性别负相关。结论:体检人群达高血压水平的比率显著高于全国高血压患病率,存在显著性别和年龄差异,与年龄、BMI、FPG、UA、TC、TG、LDL呈正相关,与HDL、性别呈负相关。     

原发性高血压患者血压变异性的临床观察

目的 :探讨原发性高血压 (EH)患者血压变异性与靶器官损害、血压增高的程度及年龄、性别的关系。方法 :对 480例 EH患者及 2 0 0例正常人 (对照组 )进行 2 4h动态血压监测 ,以测得的血压标准差作为血压变异性指标。结果 :EH组血压变异性明显大于对照组 ; 期 EH患者血压变异性明显大于 期及 期患者 ; 、 期之间血压变异性无明显差异 ;对照组及 EH组各组中男女性别之间血压变异性无显著性差异 ;EH组血压变异性随血压水平的增加而逐渐增大 ,年龄≤ 6 0岁者 ,其血压变异性随年龄的增加而增大 ,年龄 >6 0岁者 ,其血压变异性不再继续增加。结论 :EH患者血压变异性明显增加 ,且靶器官损害越重 ,血压值越高 ,在一定范围内年龄越大则血压变异性越大。     

我校2007—2009年新生入学高血压分析

目的探讨影响大学生血压水平的因素,以及该群体高血压的知晓率和治疗率,进而有针对性地开展健康教育。方法选取2007—2009年入学新生共12406名,对其血压进行测量,将其中血压偏高637名进行问卷调查,同时选取637名血压正常学生作为对照组问卷调查。结果血压偏高组男、女生血压水平比较差异显著。血压偏高组与对照组在体质指数、家族史、嗜咸、饮酒、体育锻炼、精神紧张等方面存在显著差异;而吸烟率差异不显著;该人群高血压有症状率、知晓率和治疗率分别为1.40%、9.77%和3.45%。结论性别、体质指数、家族史、嗜咸、饮酒、体育锻炼、精神紧张等都是影响该组人群血压的重要因素,而该组人群高血压的有症状率、知晓率和治疗率很低,更应加以重视。     

288例临界高血压12年预后分析

对汉中288例年龄30～60岁农民临界高血压患者随访12年。结果显示，转归确诊高血压者1．6％，仍维持临界高血压者27．2％，血压恢复正常者41．2％。临界高血压伴年龄偏大、高血压家族史、体重指数偏高或心率偏快者转归确诊高血压危险性增大。     

身体质量指数与年龄对血压的影响

目的探讨身体质量指数(BMI)和年龄、血压的关系及其影响,为高血压一级预防提供依据。方法 330例健康体检者按性别男、女分组,男228例,女102例。首先用Pearson相关方法检验BMI与年龄、血压的相关性,再对男、女各组按照BMI和年龄分组,BMI(kg/m2)的分类标准为:BMI18.50为瘦型,18.50≤BMI≤22.99为匀称,BMI22.99为肥胖;年龄的分类标准为:≤44岁为青年,45岁年龄≤59岁为中年,60岁为老年。并用成组t检验和单因素方差分析对其进行统计分析。结果 Pearson方法分析的相关结果为BMI与血压的密切程度远大于年龄与血压的关系。按BMI分组的统计学分析中,匀称组与肥胖组之间的血压有明显差异。按年龄分组的统计分析中,青、中和老年组之间的血压没有明显的差异。结论血压与BMI的相关性明显大于与年龄的相关性,不同的体重之间血压有明显的差异,而不同年龄段之间血压没有明显的差异。在青年以前将体重控制在匀称水平是高血压一级预防的一项重要措施。     

老年高血压患者血浆抵抗素水平与胰岛素抵抗的相关性

目的了解老年高血压患者血浆抵抗素水平与胰岛素抵抗的关系。方法选择41例中青年人(对照组)和43例老年人(老年组),分别分为高血压组和正常血压组,用竞争性酶联免疫吸附试验测定各组空腹血浆抵抗素水平,同时测定空腹血糖、空腹胰岛素、血脂和胰岛素敏感指数,测量受试对象腰围、臀围和腰臀比。结果老年组血浆抵抗素水平与对照组相比明显升高(P<0.05),老年组中高血压亚组血浆抵抗素与正常血压亚组相比差异无显著性。对照组高血压亚组抵抗素水平略高于正常血压亚组,但差异无统计学意义(P>0.05)。抵抗素与年龄呈正相关(r=0.31,P<0.01;r=0.28,P<0.05),与体质指数呈正相关(r=0.23,P<0.05),与胰岛素抵抗指数呈负相关(r=-0.31,P<0.05),但在各实验组中,抵抗素与体质指数无明显相关性。结论空腹血浆抵抗素水平与年龄和体质指数呈正相关,与胰岛素抵抗指数呈负相关。     

钠/锂反转运及尿血管舒缓素与少年儿童高血压

在一组年龄 10～ 15岁血压偏高及血压正常少年儿童 5年血压等随访的基础上 ,进行红细胞膜钠 /锂反转运、尿血管舒缓素及盐敏感性等测定。发现血压偏高及高血压家族史阳性少年儿童红细胞膜钠 /锂反转运速率显著增高 ,尿血管舒缓素排泄水平降低 ,且与血压及盐敏感性相关 ;钠 /锂反转运偏高或尿血管舒缓素偏低者过去 5年中血压上升幅度显著增大 ,其收缩压百分位数 (PSBP)多数上升或持续居于较高百分位次。提示红细胞膜钠 /锂反转运增强及尿血管舒缓素排泄低下作为高血压中间表现型 ,参与血压调节 ,在少年儿童高血压的发生发展中已起一定作用     

15867名3～6岁儿童心率分布特征及影响因素

目的研究儿童心率的自然规律、特点，以及地区、民族和性别等的差异及其正常值范围，为防病治病提供科学数据。方法心率、血压测定按国际统一标准，利用云南2002年16个地区15867名3-6岁城乡男、女童，分析心率在人群不同性别、年龄、城乡、地区、民族的情况，并进行单、多因素分析。结果心率随着年龄的增长而逐渐下降，女童高于男童，乡村男女童与城市男女童间无差别（P〉0．05），心率与纬度无相关性（P〉0．05），心率与血压呈正相关，对心率起作用的因子是舒张压、BMI、年龄、收缩压。结论心率的增加或减少会相应地引起收缩压和舒张压的增高或降低，心率随年龄增加而减少，心率可作为预防儿童高血压高危因素的一个参考指标。     

Blood pressure in the child and the adolescent. Effect of age, sex, height, weight and heart rate

6,391 school children in the department of Seine-Saint-Denis were studied to determine the normal limits of blood pressure, its variations with age and sex, and its correlations with height, weight and heart rate. Blood pressure has a nearly perfect Gaussian distribution. Average blood pressures increase linearly with age according to sex. Boys have higher systolic blood pressures after the age of 14 and higher diastolic blood pressures after the age of 16. The estimated incidence of hypertension was 3,1% systolic hypertension and 2.2% diastolic hypertension. There was a very close relationship between systolic and diastolic blood pressure. Average systolic and diastolic blood pressures increased very significantly with height and weight, in both sex. Heart rate decreased with age. The average blood pressure was not related to heart rate. Blood pressure charts, related to age, sex, height and weight, allow follow-up of arterial blood pressure as children grow up and may lead to a better understanding of the mechanism of hypertension.     

Blood pressure is associated with body mass index in both normal and obese children

Obesity is associated with elevated blood pressure (BP) both in adults and children. Childhood obesity has become a severe health problem, especially during the last few decades. So far there has not been any large-scale study specifically focusing on the association between obesity and BP in early life. The aim of this study is to examine systematically the association between obesity and BP in preschool Chinese children in mainland China. In 1996, measurements of weight, height, and BP values were collected in a nationwide, case-control study of 748 boys and 574 girls who ranged in age from 0.1 to 6.9 years in 8 cities in mainland China. One obese child and 1 nonobese child were matched for gender and age. The BP differences of the mean-matched pair were approximately 5 mm Hg for systolic blood pressure (SBP) and approximately 4 mm Hg for diastolic blood pressure (DBP) (P<0.05); a higher value was noted in obese children. The BP value of 19.4% children in the obese group and 7.0% children in the nonobese group was higher than the 95th percentile value (P<0.0001), which is defined as high BP by the Task Force on Blood Pressure Control in Children. Both SBP and DBP were significantly (P<0.05) positively related to body mass index (BMI) values (P<0.05) for children in obese and nonobese groups after adjustment for age, gender, and height. To be specific, an increase of 1 BMI unit was associated with, on average, an increase of 0.56 mm Hg and 0.54 mm Hg in SBP and DBP, respectively, for obese children. In nonobese children, the increase in SBP and DBP was 1.22 mm Hg and 1.20 mm Hg, respectively. An increase in the BMI is conclusively associated with elevated SBP and DBP in nonobese children. Furthermore, an increase in the adjusted BMI was associated with an increase in SBP and DBP in obese and nonobese children.     

Relationship between drinking alcohol and atherosclerotic risk factors in female Japanese workers of different ages

AIM: To determine whether age influences the relationships of drinking alcohol with blood pressure and lipids in women. METHODS: The subjects were 53,911 female Japanese workers (20-69 years old) receiving annual health checkups at each workplace. The subjects were divided into three groups by daily average amount of ethanol consumed (non-drinkers; light drinkers, less than 30g ethanol/day; heavy drinkers, 30g ethanol/day or more). Blood pressure, body mass index (BMI) and total and HDL cholesterol were measured. RESULTS: In the age groups from twenties to fifties, BMI was significantly lower in light drinkers than in non-drinkers. In the forties and fifties age groups, systolic blood pressure in heavy drinkers was higher than that in non-drinkers, while no significant difference was found between non- and heavy drinkers in the twenties and thirties age groups. Diastolic blood pressure was higher in heavy drinkers than in non-drinkers in all age groups. Blood total cholesterol tended to be lower in drinkers than in non-drinkers at ages less than 60 years, while this relation was not observed in the sixties age group. Blood HDL cholesterol and atherogenic index tended to become higher and lower, respectively, with an increase in the amount of alcohol drinking in all age groups. CONCLUSION: In elderly women, the elevating effect of drinking on systolic blood pressure is increased and the lowering effects on BMI and blood total cholesterol are decreased. These results imply that drinking alcohol has less beneficial and more harmful effects on atherosclerotic risk in elderly women.     

高血压合并阻塞性睡眠呼吸暂停患者的血压变异性

目的探讨高血压合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的血压变异性特点。方法纳入疑似OSAHS的高血压患者217例,根据睡眠呼吸暂停低通气指数(AHI)分为4组:非OSAHS组(33例),轻度OSAHS组(57例),中度OSAHS组(68例),重度OSAHS组(59例),比较各组患者血生化指标、血压及血压变异性,分析AHI与血压变异性的关系。结果 4组患者的体质量指数(BMI)和血压变异性明显不同,随睡眠呼吸暂停的严重程度增加而增大(P<0.05)。以BMI进行分层后,超重及肥胖高血压患者的夜间血压变异性随睡眠呼吸暂停严重程度的增加而增大(P<0.05)。偏相关分析显示控制年龄、BMI、血压后,AHI与24h收缩压变异性、24h舒张压变异性、白昼收缩压变异性、白昼舒张压变异性、夜间收缩压变异性及夜间舒张压变异性呈正相关(分别r=0.346,0.414,0.263,0.324,0.445,0.570,均P<0.05)。结论 AHI与血压变异性相关,睡眠呼吸暂停对夜间血压变异性影响更为明显。     

Effect of body mass index changes between ages 5 and 14 on blood pressure at age 14: findings from a birth cohort study

Weight reduction in clinical populations of severely obese children has been shown to have beneficial effects on blood pressure, but little is known about the effect of weight gain among children in the general population. This study compares the mean blood pressure at 14 years of age with the change in overweight status between ages 5 and 14. Information from 2794 children born in Brisbane, Australia, and who were followed up since birth and had body mass index (BMI) and blood pressure measurements at ages 5 and 14 were used. Systolic and diastolic blood pressure at age 14 was the main outcomes and different patterns of change in BMI from age 5 to 14 were the main exposure. Those who changed from being overweight at age 5 to having normal BMI at age 14 had similar mean blood pressures to those who had a normal BMI at both time points: age- and sex-adjusted mean difference in systolic blood pressure 1.54 (-0.38, 3.45) mm Hg and in diastolic blood pressure 0.43 (-0.95, 1.81) mm Hg. In contrast, those who were overweight at both ages or who had a normal BMI at age 5 and were overweight at age 14 had higher blood pressure at age 14 than those who had a normal BMI at both times. These effects were independent of a range of potential confounding factors. Our findings suggest that programs that successfully result in children changing from overweight to normal-BMI status for their age may have important beneficial effects on subsequent blood pressure.     

Blood pressure changes during adolescence and subsequent adult blood pressure level

Serial data were analyzed for blood pressure recorded between the ages of 9 to 18 years for 278 children and for a subset of this group whose blood pressure was measured at the age of 30 +/- 5.0 years (n = 93). Blood pressures were measured by auscultation over the antecubital fossa with the participant seated. Systolic blood pressure was recorded when the first sound was heard, and diastolic blood pressure was recorded when all sounds disappeared (fifth phase). A linear regression model was fitted to the data for each individual, and adjustments were made for regression toward the mean using maximum likelihood procedures. There were no significant correlations between the estimated initial values of blood pressure and the rate of change from 9 to 18 years of age. The associations between the levels of blood pressure at 9 years of age and at 30 years of age were significant for systolic blood pressure only in male subjects and were not significant for diastolic blood pressure in either sex. The correlations between the rate of blood pressure change from 9 to 18 years of age and blood pressure levels at 30 years of age were nonsignificant. When the initial values and the rate of change in blood pressure from 9 to 18 years of age were taken into account simultaneously, they accounted for approximately 20% of the variation in systolic blood pressure levels at 30 years of age. This finding indicates that children with higher blood pressure levels at about 9 years of age and with rapid increases in blood pressure during pubescence may have an increased risk of becoming hypertensive.(ABSTRACT TRUNCATED AT 250 WORDS)     

Relationships of body mass index with blood pressure and serum cholesterol concentrations at different ages

BACKGROUND AND AIMS: Only limited information has been available on the effects of age on the relationship between obesity and other atherosclerotic risk factors, such as blood pressure and serum lipids. The purpose of this study was to investigate the effects of age on the relationships of obesity with blood pressure and serum cholesterol concentrations. METHODS: A community-based cross-sectional study was performed on 157,902 workers in Yamagata, Japan. Blood pressure and serum total and HDL cholesterol concentrations were measured, and body mass index (BMI) and atherogenic index were calculated. The correlations of BMI with blood pressure, serum cholesterol concentrations and atherogenic index in different age groups were compared. RESULTS: BMI showed significant positive correlations with systolic and diastolic blood pressures, serum total cholesterol level and atherogenic index, and showed a significant negative correlation with serum HDL cholesterol level. The relationships of BMI with systolic and diastolic blood pressures became weaker with advancing age in both men and women after 30 and 40 years of age, respectively. The relationships of BMI with serum total cholesterol level and atherogenic index also became weaker with advancing age after 30 years of age in men and after 40 years of age in women. There was no age-dependent tendency in the relationship between BMI and HDL cholesterol, however. The above age-dependent changes were more prominent in men than in women. CONCLUSION: The relationships of obesity with blood pressure, serum total cholesterol level and atherogenic index in the elderly are much weaker than in the young.     

Risk profile in women with stroke: role of plasma fibrinogen

In 96 women with ischemic stroke, (mean age 77.9 +/- 7.4, S.D., years, body mass index, BMI = 23.7 +/- 3.91, we assessed the presence of risk factors for atherosclerosis, particularly of hyperfibrinogenemia. A control group of 96 women without relevant diseases, namely neoplasms, cardiovascular and inflammatory diseases, well matched for age and BMI was also studied. Subjects with stroke show higher values of systolic and diastolic blood pressure, total serum cholesterol, fibrinogen, hematocrit and more frequent habit of cigarette smoking. Levels of HDL-cholesterol, triglyceridemia and glycemia do not differ between the 2 groups. In stroke group fibrinogen is positively correlated with systolic and diastolic blood pressure and triglyceridemia. These findings confirm the presence of a risk profile for stroke, in which hypertension plays the most relevant role. The weight of fibrinogen in pathogenesis of stroke is likely to be related to the presence of other risk factors.     

中国人群低血压患病率及影响因素研究

目的了解我国人群低血压的患病率、危险因素以及低血压对心血管病的影响。 方法　利用1991年全国血压抽样调查的资料,进行低血压的横断面分析。低血压的定义为收缩压(SBP)≤98mmHg并且舒张压(DBP)≤60mmHg。 结果男性和女性的低血压患病率分别为2.70％和7.36％,女性明显高于男性（P<0.01）。从低年龄组到高年龄组（15～、25～、35～、45～、55～、65～岁）,低血压的患病率分别为7.62%、6.97%、4.40%、3.22%、2.65%、1.94％,随年龄的增加,低血压的患病率呈下降趋势。不同民族低血压患病率变异大。低血压患病率在地区分布上呈现南高北低的现象。Logistic回归分析显示,年龄、体重指数、饮酒、心率与低血压状态呈负相关,女性比男性更易患低血压。低血压人群的脑卒中和心肌梗死患病率明显低于正常血压和高血压人群。 提示我国人群低血压的患病率变异较大,影响因素较多;低血压可能是一种正常的生理现象,但它对于健康的确切影响需要进行前瞻性研究才能证实。