在患有抗性高血压的患者中,性交感性化后的门诊血压变化
Felix Mahfoud1, Christian Ukena, Roland E Schmieder
1Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Str, Geb 40, 66421 Homburg/Saar, Germany. Felix.Mahfoud@uks.eu
Circulation
|June 20, 2013
概括
同情性缩 (RDN) 在真正耐性高血压中有效降低24小时血压,但仅在伪耐性病例中影响办公室血压. 基线办公室静心血压预测治疗反应.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 高血压管理 高血压管理
背景情况:
- 已知以导管为基础的交感性缩 (RDN) 可以降低抗高血压的办公室血压.
- RDN对24小时门诊血压监测 (ABPM) 和真假抗性高血压的反应预测因子的影响仍然不太清楚.
研究的目的:
- 评估RDN对真正耐药高血压患者的办公室和24小时ABPM的影响.
- 评估RDN对伪抗性高血压患者的办公室和24小时ABPM的影响.
- 为了确定血压对RDN的反应的相关性.
主要方法:
- 总共研究了346名患有失控高血压的患者,根据ABPM分为真正耐药 (n=303) 和伪耐药 (n=43) 的高血压.
- 患者接受了RDN,随访评估包括办公室BP和24小时ABPM在3,6和12个月.
- 统计分析确定了BP反应的独立相关值.
主要成果:
- 在3-12个月后,RDN显著降低了办公室的缩血压 (SBP) 21.5-27.3 mm Hg和腹缩血压 (DBP) 8.9-11.7 mm Hg.
- 在真正耐药高血压中,RDN显著降低了24小时SBP (-10.1至-11.7毫米) 和DBP (-4.8至 -7.4毫米) 在3-12个月.
- 在伪抗性高血压中没有观察到对24小时ABPM的显著影响,尽管办公室BP同样降低;基线办公室SBP是BP响应的唯一独立预测因子.
结论:
- 在真正的耐高血压中,RDN有效降低了办公室和门诊血压.
- 在伪抗性高血压中,RDN主要影响办公室血压,对24小时的门诊读数没有显著影响.
- 办公室缩血压的基线是预测血压对RDN反应的关键独立相关值.
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