高血圧喫煙者における循環性シストリック血圧の上昇. ケース・コントロール研究です
S J Mann1, G D James, R S Wang
1Cardiovascular and Hypertension Center, New York Hospital-Cornell Medical Center, NY 10021.
JAMA
|May 1, 1991
まとめ
高血圧の喫煙者は,オフィスでの血圧の測定値に似ているが,非喫煙者,特に50歳以上の非喫煙者よりも,昼間の循環器内静脈血圧が高くなります. これは,喫煙高血圧患者の血圧測定におけるパラドックスを強調しています.
科学分野:
- 心臓病学 心臓病学
- 高血圧の研究 高血圧の研究
- 公衆衛生は公衆衛生である.
背景:
- 喫煙は血圧を上昇させることが知られている.
- 喫煙者のオフィスでの血圧測定は,非喫煙者と比較してこの上昇を反映していないことが多い.
- 喫煙者の伝統的な血圧測定値と実際の心血管のストレスの間には不一致がある.
研究 の 目的:
- 喫煙者と非喫煙者のオフィスにおける同様の血圧のパラドックスを調査する.
- 高血圧喫煙者および非喫煙者における24時間歩行式血圧モニタリング (ABPM) を比較する.
- 喫煙者と非喫煙者の高血圧患者の間で,年齢に関連する血圧パターンの違いを特定するために.
主な方法:
- 59人の未治療高血圧喫煙者と118人の非喫煙者高血圧患者の比較研究です.
- 診療室での血圧と24時間通院中の血圧の両方の測定.
- 年齢 (50歳以下と50歳以上) に分けて,覚醒状態と睡眠中の血圧値の分析.
主要な成果:
- オフィスの血圧は,喫煙者 (141/93 mm Hg) と非喫煙者 (142/93 mm Hg) の間で比較可能でした.
- 目覚めた時の循環器シストリック血圧は,喫煙者 (145 mm Hg) と非喫煙者 (140 mm Hg) の間で有意に高かった.
- この違いは50歳以上 (153対142mmHg) の個体では顕著でしたが,50歳未満ではそうではありませんでした.
結論:
- 50歳以上の高血圧の喫煙者は,非喫煙者よりも,昼間の循環器内静脈血圧が高くなります.
- 事務所での血圧測定は,高齢の高血圧患者の喫煙による心血管への影響を過小評価する可能性があります.
- 歩行式血圧モニタリングは,高血圧喫煙者,特に高齢者の血圧の正確な評価に不可欠です.
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