AHA & ASH2017联合科学年会:血压增高对机体的影响可能存在性别差异

2017-09-23 伊文 国际循环

高血压是导致死亡的首要原因。众所周知,两性的血压及高血压患病率的差异在青春期开始显现并可在整个育龄期持续存在。就血液动力学改变而言,血压增高时可出现每搏输出量(SV)增加、总外周阻力(TPR)增加和心率(HR)增加。但是,目前尚不清楚血压增高时上述血液动力学的改变是否存在性别差异。AHA和ASH 2017联合科学年会上发布的一项以人群为基础的最新研究探讨了血压增高对人体血液动力学影响的性别差异。

高血压是导致死亡的首要原因。众所周知,两性的血压及高血压患病率的差异在青春期开始显现并可在整个育龄期持续存在。就血液动力学改变而言,血压增高时可出现每搏输出量(SV)增加、总外周阻力(TPR)增加和心率(HR)增加。但是,目前尚不清楚血压增高时上述血液动力学的改变是否存在性别差异。AHA和ASH 2017联合科学年会上发布的一项以人群为基础的最新研究探讨了血压增高对人体血液动力学影响的性别差异。

研究者加拿大多伦多儿童医院的Catriona A Syme等对1347例受试者进行了分析,其中青少年(12~18岁)911例,女性占52%;中青年(36~65岁)426例,女性占56%。鉴于与标准诊室血压相比,常规日常活动期间的血压是更好的靶器官损害预测因素,因此,研究在为期52 min的、旨在模拟日常生活活动的干预期间,采用Finometer无创血液动力学监测仪评估收缩压、舒张压、HR、SV及TPR。

结果发现,在中青年受试者中,SV、TPR及HR对收缩压及舒张压的相对贡献存在显着的性别差异。具体来说,与男性相比,SV对女性收缩压增高的贡献更大;与女性相比,TPR对男性收缩压增高的贡献更大。就舒张压而言,对于男性及女性来说,TRP均是导致舒张压增高的主要因素,但是其贡献在男性中更显着。此外,研究发现,在为期52 min的模拟日常生活活动的干预期间,两性上述指标的差异在站立期间更显着,在精神应激时相对不明显。对青少年受试者的研究结果与上述结果相似,只是结果不显着,仅在站立时有显着差异。

上述结果提示,血压增高的血液动力学存在明显的性别差异,女性血压增高主要是由SV变化所致,而男性血压增高则主要是由TPR变化所致。因此,高血压的治疗也需要具有性别特异性。鉴于该研究仅入选了白种人受试者,未来有必要进一步针对其中种族人群进行研究,以确定上述结果是否存在种族差异。

原始出处:
American Heart Association. High Blood Pressure Reasons Differ by Gender in Teens; Young Adults. ScienceDaily Sep 22, 2017.

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    2017-09-27 虈亣靌

    谢谢分享.学习了

    0

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    2017-09-25 zhaohui6731
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    2017-09-25 kksonne
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    2017-09-25 liuxiaona
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    2017-09-25 liuxiaona
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    2017-09-25 飛歌

    这个不错哦学习了

    0

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    2017-09-24 jet747

    有意思.谢谢分享

    0

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    2017-09-23 135****7952平儿

    学了.........

    0

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    2017-09-23 有备才能无患

    高血压是导致死亡的首要原因.众所周知.两性的血压及高血压患病率的差异在青春期开始显现并可在整个育龄期持续存在.

    0

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≥60岁高血压病人控制血压在较高或较低水平的药物治疗——美国医师协会和美国家庭医师学会临床实践指南

针对≥60岁的高血压病人治疗中较高和较低降压目标的利弊,美国医师协会(ACP)和美国家庭医师学会(AAFP)共同制订了这一指南,为临床治疗提供证据及治疗建议。

孙英贤教授:从近期指南共识争议看高血压治疗的热点问题

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一例高血压,一直被误诊,到底是什么问题?

也许有人会问,血压高不高,一测便知道,还有什么误诊不误诊?我这里说的误诊病例,不是没有发现高血压,而是忽略了高血压的原因追查,没有针对性治疗,以致于血压久未控制。

Plos Med:自我监控血压可达到的降血压效果。

自我监控血压(BP)似乎可降低高血压患者的BP,但重要的问题仍然是如何有效的落实,此外,尚不清楚哪一个群体会获益最大。现研究人员进行单一患者数据(IPD)的Meta分析来协助更好的了解自我监控血压对于降BP和控制高血压的效果。

抗高血压药的用药禁忌

高血压病是中老年人常见的一种慢性疾病,除了改善患者的饮食习惯及生活方式外,应使用抗高血压药物进行长期或终生治疗。抗高血压药物种类较多,如应用不当不仅达不到治疗目的,更有可能引起多种副作用或不良反应。下面就来介绍下临床上常用的一线降压药的用药禁忌及注意事项。敲黑板,划重点!一、利尿剂其降压机制是利钠排水,使高血容量负荷降低而发挥降压作用。包括袢利尿剂、噻嗪类利尿剂以及保钾利尿剂。代表药物:氢氯噻嗪、

新诊断高血压的患者,应该检查哪些项目?

等,这都有助于医生更为准确的制定治疗决策,特别是确定是否需要服用阿司匹林和他汀。