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目的探讨诊室、随诊间、24h动态收缩压与肱踝动脉脉搏波传导速度(baPWV)的关系。方法在参加开滦研究队列第3次健康体检的人群中,采取整群抽样的方法随机抽取年龄≥60岁的开滦集团离退休员工3064名进行24h动态血压监测和baPWV等检查。分别按照诊室、随诊间、24h、日间、夜间收缩压中位数将观察对象分为两组,比较年龄、体质量指数、空腹血糖等基线资料和baPWV的情况;采用多元线性回归分析各种收缩压对baPWV的影响。结果共纳入资料完整的研究对象930(男性588、女性342)名进行分析。诊室、随诊间、24h、日间、夜间收缩压的中位数分别为142.0、139.0、128.5、130.8和121.1mm Hg,baPWV的中位数为1731cm/s。高收缩压组的baPWV值,左、右侧baPWV值及baPWV≥1731cm/s的检出率均高于低收缩压组(P<0.01)。多元线性回归分析显示:诊室、随诊间、24h、日间、夜间收缩压均与baPWV呈正相关,其每增加1 mm Hg,baPWV分别增加9.13、10.79、9.68、9.14、8.26cm/s(均P<0.01);去除24h收缩压后,比较诊室、随诊间、日间、夜间收缩压对baPWV的影响,并校正其他相同的混杂因素,结果显示诊室收缩压与baPWV的相关性较大(β=0.36)。结论诊室、随诊间、24h、日间、夜间收缩压均与baPWV呈正相关,其中诊室收缩压与baPWV相关性最大。
Objective To investigate the relationship between ambulatory systolic blood pressure (24h) and pulse wave velocity (baPWV) of brachial-ankle artery at the clinic, during follow-up, 24h. Methods In the third group of Kailuan study cohort, we took 3064 Kailuan Group retired employees aged 60 years or older randomly to conduct ambulatory 24h ambulatory blood pressure monitoring and baPWV examination by cluster sampling method. The subjects were divided into two groups according to the median of systolic pressure at clinic, follow-up room, 24h, daytime and nighttime respectively. Baseline data such as age, body mass index, fasting blood glucose and baPWV were compared. Multivariate linear regression analysis Effect of systolic blood pressure on baPWV. Results A total of 930 subjects (588 male and 342 female) were included in the study. The median systolic blood pressure in clinics, follow-up clinics, 24h, daytime and nighttime was 142.0, 139.0, 128.5, 130.8 and 121.1 mm Hg respectively. The median baPWV was 1731 cm / s. The baPWV values, the baPWV values of the left and right sides and the detection rates of the baPWV≥1731 cm / s were higher in the high systolic blood pressure group than those in the low systolic blood pressure group (P <0.01). Multivariate linear regression analysis showed that the systolic blood pressure at clinic, clinic, 24h, daytime and night were positively correlated with baPWV, and baPWV increased 9.13,10.79,9.68,9.14,8.26cm / s for each 1 mm Hg increase P <0.01). After 24h systolic blood pressure was removed, the effects of systolic, diastolic, daytime and night systolic blood pressure on baPWV were compared and other similar confounding factors were corrected. The results showed that the systolic blood pressure in clinic was significantly correlated with baPWV β = 0.36). Conclusions The systolic blood pressure at clinic, at follow-up, 24h, daytime and nighttime are all positively correlated with baPWV, of which clinic systolic blood pressure has the highest correlation with baPWV.