Hypertension:年轻难治性高血压患者的危险因素及表型分析!

2017-03-28 xing.T MedSci原创

在顽固性高血压患者中,年轻患者有一个独特的表型,相比于老年患者,其特征是重叠的危险因素和合并症,包括肥胖、高醛固酮和高膳食钠摄入量

顽固性高血压,定义为尽管使用3种及以上抗高血压药物治疗血压>140/90mmHg,是一种公认的临床疾病。与更容易控制的高血压患者相比,顽固性高血压患者血管疾病的风险增加。年轻人冠心病死亡率停滞不前或上升。近日,血管权威杂志Hypertension上发表了一篇研究文章,该研究的目的是归纳年轻顽固性高血压患者的表型和危险因素,由于在这个队列中缺乏心血管疾病风险的数据。

研究人员进行了一项横断面分析,预先定义的年龄组为一个大型的、种族不同的队列,包含有2170例转诊到阿拉巴马大学伯明翰分校高血压诊所的患者。患者(n=2068)符合纳入标准,并按年龄分组,即≤40岁(整个队列的12.7%患者)、41-55岁(32.1%)、56-70岁(36.1%)和≥71岁(19.1%)。

年龄≤40岁的患者相比于年龄≥71岁的患者高血压发病较早(24.7±7.4 vs. 55±14.1岁;P<0.0001)、肥胖率更高(53.4% vs. 26.9%;P<0.0001)、血浆醛固酮水平更高(11.3±9.8 vs. 8.9±7.4ng/dL;P=0.005)、血浆肾素活性更强(4.9±10.2 vs. 2.5±5ng/ml/h;P=0.001)、24h尿醛固酮水平更高(13.4±10 vs. 8.2±6.2µg/24h;P<0.0001)以及钠排泄增加(195.9±92 vs. 146.8±67.1mEq/24 h;P<0.0001)。

在顽固性高血压患者中,年轻患者有一个独特的表型,相比于老年患者,其特征是重叠的危险因素和合并症,包括肥胖、高醛固酮和高膳食钠摄入量。

原始出处:

Lama Ghazi,et al. Distinctive Risk Factors and Phenotype of Younger Patients With Resistant Hypertension.Hypertension.2017.https://doi.org/10.1161/HYPERTENSIONAHA.116.08632

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    2017-10-19 feather89
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    2017-03-30 freve
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    2017-03-30 tastas

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