河北医科大学学报

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肥胖或超重冠心病住院患者餐后低血压的临床观察#br#

  

  1. 1.河北医科大学第二医院心内一科，河北 石家庄 050000；2.河北医科大学临床学院实验中心，
    河北 石家庄 050031；3.河北省人民医院心内六科，河北 石家庄 050051
  • 出版日期:2019-02-25 发布日期:2019-01-16
  • 作者简介:张亚楠（1980-），女，河北石家庄人，河北医科大学第二医院主治医师，医学硕士，从事心血管内科疾病诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题（20170570）

The clinical observation of postprandial hypotension in patients with obesity or overweight and coronary heart disease#br#

  1. 1.The First Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang
    050000, China; 2.Experimental Center of Clinical College, Hebei Medical University,
    Shijiazhuang 050031, China; 3.The Sixth Department of Cardiology, Hebei
    General Hospital, Shijiazhaung 050051, China
  • Online:2019-02-25 Published:2019-01-16

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摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗观察住院肥胖或超重冠心病患者餐后低血压（prognosis for postprandial hypotension,PPH）的发病率、临床特征、相关影响因素、住院期间不良事件及中期预后。
〖HTH〗方法〖HTSS〗〖KG*2〗152例肥胖或超重冠心病患者，行24 h动态血压监测，依据PPH诊断标准分为PPH组（n=37）和NPPH组（n=115），对比2组临床特征、PPH相关危险因素、不良事件发生情况及随访26个月全因死亡、心脑血管等不良事件的预后。
〖HTH〗结果〖HTSS〗〖KG*2〗152例肥胖或超重冠心病患者中发生PPH 37例（24.3%），PPH组合并高血压病史和服用钙离子拮抗剂药物比例高于NPPH组；三餐中早餐和晚餐后PPH发生率较午餐高；Logistic回归分析显示，基础收缩压水平、利尿剂与PPH发生呈正相关；2组住院期间发生心脑血管事件差异无统计学意义；随访26个月结果表明，PPH组全因死亡率高于NPPH组。
〖HTH〗结论〖HTSS〗〖KG*2〗肥胖或超重冠心病患者住院期间PPH发生率为24.3%，早餐和晚餐后容易发生PPH，基础收缩压水平高和口服利尿剂增加PPH的发生，PPH增加患者中期全因死亡。

关键词: 冠心病, 餐后低血压, 肥胖, 超重

Abstract: ［Abstract］ Objective〖HTSS〗〓To investigate the incidence rate, clinical features, risk factors and adverse events during hospitalization and midterm prognosis for postprandial hypotension(PPH) in obesity or overweight patients with coronary heart disease(CHD).
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 152 obesity or overweight patients with CHD were selected as the subjects. The blood pressure of patients were monitored by 24 hour ambulatory blood pressure monitor. Subjects were classified into PPH group(n=37) and nonPPH group(NPPH, n=115) according according to PPH diagnostic criteriae. The clinical characteristics of the two groups were compared and the risk factors of PPH, the incidence rate of adverse events and the prognosis of allcause death, cardiovascular and cerebrovascular adverse events were studied.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓Among 152 obese or overweight patients with CHD, 37 cases had PPH, the incidence was 24.3%. The proportion of combined with hypertension and taking calcium antagonists in PPH group was higher than that of NPPH group. The incidence rate of PPH at breakfast and dinner was higher than that at lunch. Logistic regression analysis showed that high systolic blood pressure level and oral diuretics were positively correlated with the occurrence of PPH. There was no significant difference in the incidence rate of cardiovascular and cerebrovascular events between the two groups during hospitalization. The 26month followup showed that the incidence of allcause mortality in PPH group was higher than that in NPPH group.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The incidence rate of PPH in obese or overweight patients with CHD was 24.3%. PPH might be likely to occur after breakfast and dinner. High systolic blood pressure and oral diuretics might increase the incidence rate of PPH, and PPH might increase the midterm allcause mortality.

Key words: coronary disease, postprandial hypotension, obesity, overweight

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