Hypertension:高血压和非高血压受试者收缩压与脑灌注的不同关系

2018-11-13 xing.T MedSci原创

然而,在高血压受试者中,似乎存在着SBP中间范围窗,其灌注水平最大。

虽然人们越来越认同高血压与脑血管损害有关,但血压(BP)与脑血流之间的关系尚未完全明确。目前尚不清楚BP处于何种水平以及治疗目标范围对于脑灌注最佳。此外,关于BP如何影响海马灌注的数据有限,海马是一种与记忆密切相关的结构。

近日,血管权威杂志Hypertension上发表了一篇研究文章,研究人员对无痴呆或临床表现卒中的老年人进行了横断面(n=445)和纵向(n=185)研究,这些参与者接受了临床检查和脑灌注评估(年龄为69.2±7.5岁,62%为女性,45%为高血压患者)。线性模型用于评估基线BP与血流的关系,并评估BP的变化如何影响灌注的变化。

在整个组中,收缩压(SBP)与大脑皮质(β=-0.13,P=0.005)和海马血流(β=-0.12,P=0.01)呈负相关。值得注意的是,这种负相关性在没有高血压的受试者中较为明显,高血压患者SBP与海马血流呈二元关系(β=-1.55,P=0.03):SBP中位数约125mmHg的参与者灌注最高。纵向地,在高血压受试者中,灌注在低基线SBP时随着SBP的增加而增加,但在高基线SBP时随着SBP的减少而增加。大脑皮质和海马灌注随着SBP的增加而降低。

然而,在高血压受试者中,似乎存在着SBP中间范围窗,其灌注水平最大。

原始出处:

Lidia Glodzik,et al.Different Relationship Between Systolic Blood Pressure and Cerebral Perfusion in Subjects With and Without Hypertension.Hypertension.2018. https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.118.11233

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一个有外周动脉疾病的人,心梗风险会增加5倍,脑卒中以及死亡风险增加2倍。那么中国有多少外周动脉疾病患者?近日,国家心血管病中心王增武教授和高润霖院士等进行的全国性调查显示,中国≥35岁人群外周动脉疾病患病率为6.6%,按后者估算,全国约有4530万外周动脉疾病患者,但仅0.2%接受了血运重建治疗。外周动脉疾病由踝肱指数和爱丁堡间歇性跛行问卷定义,踝臂指数(ABI)≤0.9或有间歇性跛行即诊断。研究

Int Arch Otorhinolaryngol:老年人中,听力损失、高血压和糖尿病之间可能的相关性研究

衰老可以引起身体结构的持续性变化,并且能够导致临床障碍,而生命的正在增加,尤其是在发展中国家。最近,有研究人员在老年人中评估了听力损失的流行度,并且探究了听力损失与高血压和糖尿病(DM)之间可能的相关性。研究是一个代表性的研究,包括了519名老年人,年龄均在60岁以上。他们经历了听觉评估(纯音听觉测试),并且填写了一个并发症调查问卷,该调查问卷包括了年龄、性别、鼻炎和医疗历史情况,并且还考虑到了D