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目的寻找引起晨间血压升高的危险因素。方法将高血压患者分为晨峰组和非晨峰组,检测血液中血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、生长激素(GH)、皮质醇(COR)水平。分析晨峰睡-谷值与AngⅡ、ALD、GH、COR的相关性。结果老年原发性高血压患者主要为低肾素型高血压。晨峰组与非晨峰组在性别、年龄、体质量指数(BMI)、血脂和高血压病程方面无显著性差异。晨峰组的AngⅡ、ALD均高于非晨峰组(P<0.05),血GH和COR也均显著增高(P<0.01)。相关分析结果显示,晨峰组的晨峰睡-谷值与AngⅡ(r=0.42,P<0.01)、ALD(r=0.28,P<0.05)、GH(r=0.45,P<0.01)、COR(r=0.32,P<0.01)均呈现正相关。结论晨间血压升高与肾素血管紧张素系统激活密切相关,也与血液中生长激素、皮质醇浓度过高有密切关系。
Aim To find out the risk factors of morning blood pressure increase. Methods Hypertensive patients were divided into two groups: morning peak group and non-morning peak group, blood levels of plasma renin activity (PRA), angiotensin Ⅱ (AngⅡ), aldosterone (ALD), growth hormone (GH) and cortisol )Level. Analysis of the correlation between morning sleep - trough value and Ang Ⅱ, ALD, GH, COR. The results of elderly patients with essential hypertension are mainly low renin hypertension. There was no significant difference in the course of gender, age, body mass index (BMI), blood lipid and hypertension between the morning peak group and the non-morning peak group. AngⅡ and ALD in morning peak group were significantly higher than those in non-morning peak group (P <0.05), and blood GH and COR were also significantly increased (P <0.01). The results of correlation analysis showed that the peak-sleep-trough amplitude of morning peak was positively correlated with AngⅡ (r = 0.42, P <0.01), ALD (r = (r = 0.32, P <0.01) showed a positive correlation. Conclusions Morning blood pressure is closely related to the activation of the renin-angiotensin system and also closely related to the excess of growth hormone and cortisol in the blood.