2019年高血压与血管损伤 高平进.pptVIP

-20 -10 0 10 20 -0.8 -0.4 0 0.4 0.8 Δ PP(mmHg) Δ AASI -60 -40 -20 0 20 40 -0.8 -0.4 0 0.4 0.8 Δ SBP(mmHg) Δ AASI The decrease of AASI (ΔAASI) was significantly associated with the reduction of SBP(ΔSBP ) and pulse pressure( ΔPP), even after adjusting for age , gender, height, baseline 24-h BP ,PP , and heart rate (HR), nocturnal BP fall. 2009 ESH post 0.44 0.45 0.46 0.47 0.48 0.49 0.50 0.51 0.52 0.53 unadjusted adjusted Non-stroke Stroke 47 48 49 50 51 52 53 54 55 unadjusted adjusted Non-stroke Stroke Figure AASI 24-h PP AASI in hypertensives with and without stroke 2009 ESH post 颈总动脉 IMT ，本研究中应用 PHILIPS HD11EX 超声仪提供的 Qlab 软件自动测量， IMT0.9mm 定义为增厚， IMT1.3mm 定义为斑块形成。图 a 为正常颈总动脉 IMT ；图 b 为颈总动脉 IMT 增厚；图 c 为颈总动脉粥样硬化斑块形成（箭头所示）。 动脉中内膜厚度 (IMT) 基础状态下肱动脉直径图 反应性充血后肱动脉直径图 FMD=( 反应性充血后直径 - 基础状态下直径 )/ 基础状态下直径 血流介导的血管舒张 (FMD) r P value Age(years) -0.235 0.001 BMI(kg/m 2 ) -0.227 0.001 Waist(cm) -0.244 0.001 Waist-Hip ratio -0.200 0.001 hs-CRP(mg/L) 0.063 0.298 TC(mmol/L) -0.043 0.475 TG (mmol/L) -0.083 0.164 HDL-C (mmol/L) 0.186 0.002 LDL-C (mmol/L) -0.034 0.572 Blood-fasting glucose(mmol/L) -0.059 0.314 SBP(mmHg) -0.125 0.036 DBP(mmHg) 0.055 0.355 PP(mmHg) -0.187 0.002 History of hypertension(years) -0.202 0.001 Correlation of FMD with cardiovascular risk factors Xu JZ ， et al J human hypertension 2009 Correlation of FMD with target organ damage (TOD) Xu JZ ， et al J human hypertension 2009 Characteristics No TOD (n=61) One TOD (n=113) Two TOD (n=59) ≥ ThreeTOD (n=47) Age (years) 53 ± 10 59 ± 8 ** 63 ± 9 ** ? 64 ± 9 ** ? Gender, F/M 28/33 55/58 18/41 17/30 BMI (kg/m 2 ) 24.49 ± 2.57 25.50 ± 2.97 * 26.16 ± 3.45 ** 26.48 ± 2.54 ** Waist (cm) 85.98 ± 8.15 87.38 ± 8.31 90.10 ± 9.92 ** 92.55 ± 8.22 ** ? WHR (cm/cm) 0.89 ± 0.05 0.89 ± 0.05 0.91 ± 0.05 * ? 0.93 ± 0