李海明，段淼，陈念，张源波，金婧茹，汪晓芬，尚晓东，和渝斌



临床研究

高血压家族史对隐形高血压发病及心脏损害的影响

李海明，段淼，陈念，张源波，金婧茹，汪晓芬，尚晓东，和渝斌

目的：探讨高血压家族史对隐形高血压发病及其造成的心脏损害的影响。

方法：连续入选2010-01至2015-04间于我院心血管内科就诊的隐形高血压患者250例进入隐形高血压组；原发性高血压患者250例进入高血压组；正常血压者250例进入正常血压组。观察高血压家族史及一般资料，常规生化及超声心动图等检查结果。

结果：（1）隐形高血压组高血压家族史阳性70例，所占比例28%；高血压组87例，所占比例34.8%；正常血压组26例，所占比例10.4%。隐形高血压组高血压家族史者阳性所占比例较正常血压组明显增高（P＜0.001），与高血压组比较差异无统计学意义（P＞0.05）。对三组受试者的临床资料进行Logistic多因素回归分析，可见高血压家族史阳性及体重指数与隐形高血压（r=1.468，r=0.173）及高血压发生（r=1.195，r=0.086）呈正相关，提示高血压家族史阳性及体重指数是隐形高血压及高血压发生的危险因素。（2）隐形高血压组较正常血压组左心室质量指数［（85.64±17.7）g/m2比（80.50±15.53）g/m2］、主动脉瓣口最大血流速度［（115.74±16.54）cm/s比（112.40±14.21）cm/s］增高（P＜0.05）；隐形高血压组中高血压家族史阳性患者左心室质量指数［（89.22±19.08）g/m2比（84.25±16.99）g/m2］、主动脉瓣口最大血流速度［（119.19±14.97）cm/s比（114.39±16.96）cm/s］高于高血压家族史阴性患者（P＜0.05），差异有统计学意义。

结论：有高血压家族史的人群患隐形高血压的危险性增加，且心脏损害程度更大。关键词 高血压；高血压家族史；心脏

Abstract

Objective： To investigate the impact for family history of hypertension on masked hypertension （MH） morbidity with relevant cardiac damage.

Methods： Our research included in 3 groups： MH group， n=250 consecutive patients treated in our hospital from 2010-01 to 2015-04， Hypertension group， n=250 and Control group， n=250 subjects with normal blood pressure. The family history of hypertension， general clinical information， routine biochemical indexes and the findings of echocardiography were studied and compared among different groups.

Results： ①There were 70 （28%） patients with family history of hypertension in MH group， 87 （34.8%） in Hypertension group and 26 （10.4%） in Control group. The ratio of family history of hypertension in MH group was higher than Control group， P＜0.001， while it was similar between MH group and Hypertension group， P＞0.05. Logistic regression analysis presented that family history of hypertension and body mass index were positively related to the morbidities of MH （r=1.468，r=0.173） and hypertension （r=1.195， r=0.086）. ② Compared with Control group， MH group had increased left ventricular mass index （85.64 ± 17.7） g/m2vs （80.50 ± 15.53） g/m2and the maximum blood flow velocity of aortic valve （115.74 ± 16.54） cm/s vs （112.40±14.21） cm/s， all P＜0.05. In MH group， compared with those without family history of hypertension， the patients withfamily history had the higher left ventricular mass index （89.22 ± 19.08） g/m2vs （84.25 ± 16.99） g/m2and the maximum blood flow velocity of aortic valve （119.19 ± 14.97） g/m2vs （114.39 ± 16.96） g/m2， all P＜0.05.

Conclusion： The subjects with family history of hypertension had the higher risk of MH morbidity with more severe cardiac damage.

（Chinese Circulation Journal， 2016， 31：654.）

隐形高血压（masked hypertension，MH）是一种特殊类型的高血压，1999年Liu等［1］首先描述了这一临床现象，2002年Pickering等［2］将其命名为MH。……