运动锻炼对原发性高血压患者治疗作用的研究

目的:探讨运动锻炼对原发性高血压(EH)患者治疗的作用。方法:将18例EH(轻度10例为A组,中度8例为B组)患者经三个月的运动(散步、慢跑及太极拳等)治疗,进行诊断和疗效判定;A、B两组的疗效以及全部患者治疗前、后的血压值分别进行比较。结果:经诊断11例血压达到正常,6例轻度,1例中度:按疗效标准判定,显效12例,有效5例,无效1例,总有效率94.4%;A组的疗效优于B组(P<0.01);治疗后的血压明显降低(P<0.01)。结论:适当的运动锻炼对轻、中度EH患者疗效显著,是一种较好的降压疗法;轻度EH患者的疗效更显著,更适合运动疗法;散步、慢跑及太极拳等运动组合是一种治疗轻、中度EH有效的运动处方。     

Serum calcium levels in patients with essential hypertension and their first degree relatives

Calcium plays an important role in the pathophysiology of essential hypertension. Serum calcium levels were measured in 117 subjects with essential hypertension and 77 first-degree relatives. The results showed that serum calcium levels were significantly (p<0.01) decreased in both males and females with essential hypertension and their first-degree relatives when compared with the normotensive controls. This is the first study in Indian population.     

针药联合治疗阴虚阳亢型血压病的疗效观察

目的:观察中药与针刺并用治疗高血压的临床疗效。方法:将80例高血压病患者随机分为两组,对照组40例给予西药培哚普利片,治疗组40例在西药基础上加用七味调压颗粒配合针刺风池穴,4周为1疗程,观察2个疗程。结果:在降低血压和改善血管内皮细胞功能方面治疗组均优于单纯降压西药培哚普利,临床症状改善也单纯西药组。结论:七味调压颗粒配合针刺风池穴治疗高血压病疗效显著,值得进一步研究。     

Role of Vitamin D Supplementation in Hypertension

Role of Vitamin D supplementation was studied in patients with hypertension. One hundred hypertensive patients (group I) were given conventional antihypertensive drugs while another 100 patients (group II), in addition, were supplemented with Vitamin D₃ (33,000 IU, after every 2 weeks, for 3 months). Besides diastolic and systolic blood pressure, serum calcium, phosphorous, alkaline phosphatase, albumin, albumin-corrected calcium, and 24 h urinary creatinine levels were estimated in both the groups before the start of treatment and after 3 months. Vitamin D supplementation showed a more significant decrease in systolic blood pressure. This group also showed a significant increase in serum calcium as well as albumin-corrected calcium with a decrease in phosphorous. Results of the study confirm that Vitamin D supplementation has a role in reducing blood pressure in hypertensive patients and that it should be supplemented with the antihypertensive drugs. More extensive studies with a larger group, to draw a definite conclusion, are in progress.     

高血压病和颈动脉内膜功能相关性的研究进展

高血压病是全身系统性疾病,其主要危害是血管病变所引起的并发症。目前对高血压血管病变的研究很多,但早些时候人们往往更注重研究高血压和血管的一些形态学指标的相关性,如颈动脉斑块、内-中膜厚度(IMT)等,但临床实际工作中发现,单纯从颈动脉结构变化来评价高血压病有其局限性,近年对血管功能方面的研究逐渐受到人们的重视。本文通过汇总并整理国内外对高血压病和颈动脉内膜功能相关性的研究文献,以利于其他学者研究参考。     

Child maltreatment and blood pressure in young adulthood

Adverse childhood experiences are associated with hypertension in older adults. This study assessed whether an association between child maltreatment and blood pressure is detectable in young adults and whether any association differs by sex or is modified by genetic polymorphisms known to be involved in stress sensitivity. We examined these patterns in a sample of 12,420 young adults ages 24–32 years who participated in Wave IV of the National Longitudinal Study of Adolescent Health. Participants retrospectively reported history of physical, emotional, or sexual abuse before age 18 years. Participants with a systolic blood pressure (SBP) ≥140 mmHg or a diastolic blood pressure (DBP) ≥90 mmHg were classified as hypertensive. We used sex-stratified linear and logistic regression models to assess associations between each type of childhood maltreatment and SBP, DBP, and hypertension. We created interaction terms to assess for effect modification of any relationship between maltreatment and blood pressure by sex or SLC64A genotype. Fifteen percent of females and 31.5% of males were hypertensive. Frequent physical abuse in childhood was reported by 5%, frequent emotional abuse by 12%, and any sexual abuse by 5%. No association was observed between abuse history and blood pressure in either males or females, nor was effect modification present by SLC64A genotype. Child maltreatment exposure was not associated with blood pressure or hypertension in young adults in this study. Future studies should investigate additional critical windows for the effect of child maltreatment on cardiovascular health.     

天麻钩藤饮对高血压病肝阳上亢证患者超氧化物歧化酶的影响

目的：观察天麻钩藤饮对高血压病（肝阳上亢型）患者血浆超氧化物歧化酶（SOD）的影响。方法：采用随机对照方法，观察天麻钩藤饮组（30例）和对照组（30例）治疗前后血压水平及血浆超氧化物歧化酶的变化。结果：两组治疗后血压明显降低，超氧化物歧化酶明显增高（P〈0．01，P〈0．05），组间比较无显著差异（P〉0．05）。结论：天麻钩藤饮能显著升高高血压病患者血浆超氧化物歧化酶的水平。     

Effect of felodipine on the serum lipid profile of patients with hypertension

Forty patients suffering from mild to moderate degree of hypertension were put on felodipine. Their lipid profile was analysed before the start of their therapy and consecutively at two and four months after starting felodipine. There was a statistically significant fall in the levels of serum cholesterol, serum triglycerides and serum total lipids; though no appreciable variation was observed in HDL and LDL cholesterol levels. At baseline there were a few patients who had higher than the normal range of the serum lipid profile. Analysis of these patients showed a highly significant fall in the levels of serum cholesterol, serum triglycerides, serum LDL-cholesterol and serum total lipids i.e. felodipine modified the lipid profiles of hypertensive patients in a positive way.     

高血压性脑出血患者的观察与护理

目的：探讨护理措施及康复指导对高血压性脑出血患者治疗效果的作用。方法：随机抽取我院自2011年1月至2013年12月62例住院治疗的高血压性脑出血患者,作回顾性分析,总结护理经验及康复指导措施,为救治今后接诊的高血压性脑出血患者提供参考依据。结果：通过采取常规的护理措施及预防并发症的护理措施后,62例高血压性脑出血患者中基本痊愈36例、部分恢复22例、死亡4例。结论：对高血压性脑出血患者在临床治疗期间进行有效的护理措施及康复指导,可提高治愈率,有效降低死亡率及致残率,提高患者的生活质量。     

C677T MTHFR Gene Polymorphism is Contributing Factor in Development of Renal Impairment in Young Hypertensive Patients

Homocysteine concentration affected by the activities of the enzymes methylene tetra-hyrdofolate reductase (MTHFR). Polymorphisms in MTHFR gene associated with an impairment of MTHFR activity. Hyperhomocysteinemia is a result of single nucleotide polymorphisms (SNPs) in MTHFR 677 C>T that can cause homocysteine levels in the blood to increase. The purpose of this study is to investigate the relationships between MTHFR C677T (rs1801133) gene polymorphism, changes in homocysteine concentrations and progress of renal impairment in young adult hypertensive patients. Two hundred young hypertensive patients (age 21–24 years) were involved in this study; they were classified into patients with and without renal impairment in addition to 200 age and sex matched healthy controls. All participants were submitted to laboratory investigations as assay of MTHFR gene polymorphism C677T (rs1801133) by PCR/RFLP, determination of lipid profile, homocysteine and folic acid concentrations in addition to urinary albumin creatinine ratio (UACR). The levels of both homocysteine and UACR in the TT genotype patients were higher than those in the CC genotype group. Individuals who carry the T allele were more risky to hypertension and progress to early renal impairment in young age compared with those carrying the C allele [OR 2.02 (1.33–3.08), P < 0.001]. Genetic variants of C677T MTHFR gene and hyperhomocysteinemia may be responsible for rapid progress of renal impairment in Egyptian young age hypertensive patients. TT genotype or T allele may be considered as a predisposing factor for both elevated Hcy levels and the development of renal impairment. This study believed that lowering of homocysteine level can reduce renal impairment of hypertensive patients.