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。
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.
目的:探讨小剂量吲哒帕胺联合比索洛尔治疗原发性高血压患者的安全性和疗效。方法: 60例初诊的高血压Ⅰ级、Ⅱ级患者,随机分为治疗组及对照组。治疗组予以吲哒帕胺25mg/次,及比索洛尔25mg/次,每天早晨7时服药1次;对照组单用吲哒帕胺25mg/次,每天早晨7时口服1次,疗程8周。结果: 两组患者血压(收缩压及舒张压)均有下降,但以治疗组血压下降明显。治疗组显效13例,有效14例;对照组显效8例,有效15例;治疗组总有效率为90%,治疗组无效率为10%;对照组有效率767%,无效率233%,2组疗效差异有统计学意义(Plt;005)。两组不良反应相似,治疗前后生化指标变化差别无统计学意义。结论:比索洛尔联合吲哒帕胺治疗原发性高血压安全有效,对糖、脂代谢无明显影响。
Objective To analyze the current state, evaluate the accuracy, and determine the influencing factors of hypertension-related subscriptions from official health WeChat accounts. Methods The 36 official health WeChat accounts on the WeChat official accounts monthly list │ September 2022 China WeChat Top 500·New Rank certification were searched using the term "hypertension". We identified diabetes-related subscriptions published from April 1, 2022 to September 30, 2022. The accuracy of subscriptions was analyzed according to the consistency with clinical practice guidelines and was independently assessed by two specialists. SPSS 22.0 software was used for data analysis. Results One hundred and one subscriptions from 36 official health WeChat accounts were included. Forty-seven (46.5%) subscriptions were evaluated as consistent, seven (6.9%) subscriptions were evaluated as inconsistent, and forty-seven (46.5%) subscriptions were evaluated as unconfirmed. The differences between the numbers of reads, "wow" and "like" per thousand reads, were statistically significant. Consistency rates were higher for tweets backed by evidence and experts, and for tweets posted by public figures with the accreditation type "government". Conclusion Hypertension tweets have a good audience base, some of the content is inconsistent with current clinical guideline recommendations, and readers have little ability to screen them. There is a need to develop and improve the review mechanism for writing and publishing hypertension tweets on WeChat.
目的 探索缺血性脑卒中患者溶栓前血压管理和预后的相关性，并分析溶栓前血压管理考虑颅内外血管状态的必要性。 方法 计算机检索PUBMED数据库，并辅以其他检索，对所有涉及溶栓前血压的文献进行整理，并根据“溶栓类型、是否进行溶栓前血压管理、是否进行溶栓前血管评估”对文献进行分类，对其溶栓后的症状性颅内出血率进行分析对比。 结果 大多数静脉溶栓文献无血管评估的数据，其出血率波动于较高水平；进行了血管评估，而未提及血压管理或虽未进行血压管理，但所有患者的血压符合指南中对于血压的要求的文献也呈现了较高的出血率；有1篇进行了血管评估的动脉溶栓文献没有症状性颅内出血事件发生。 结论 当前证据表明现有的溶栓前血压管理模式还不够完善，这也在一定程度上可以解释目前较高的溶栓后症状性出血率。合理的溶栓前血压管理模式有待进一步探索。溶栓前血压管理考虑颅内外血管状态，根据血管病变程度对溶栓前血压进行分级管理可能会成为一个较佳的血压管理模式。
Blood pressure variability (BPV) is a novel predictor related to blood pressure level, and a large number of studies based on the hypertension cohort have shown that BPV is an independent predictor of target organ damages and cardiovascular adverse outcomes. Due to the significant hemodynamic changes, BPV in patients with chronic kidney disease (CKD) and hemodialysis is higher than the simple hypertension cohort, suggesting that BPV may be of great significance to patients with chronic kidney disease and hemodialysis. In recent years, studies based on CKD and hemodialysis cohort have published in succession whose results revealed that BPV of this cohort is of great prognostic significance for predicting target organ damages and cardiovascular disease risks. This article aims to provide an overview on these research, so as to survey and predict the clinical significance of BPV in CKD and hemodialytic patients.