Correlation of morning blood pressure surge with severity of coronary artery lesions in essential hypertension patients with or without type 2 diabetes mellitus

王雨东; 李传伟; 何多芬; 曾春雨; 张小群; 温春兰; 杨成明

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Correlation of morning blood pressure surge with severity of coronary artery lesions in essential hypertension patients with or without type 2 diabetes mellitus

更新时间：2026-01-09

- Correlation of morning blood pressure surge with severity of coronary artery lesions in essential hypertension patients with or without type 2 diabetes mellitus
- Journal of Army Medical University Vol. 39, Issue 1, Pages: 89-94(2017)
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  CLC： R543.3;R544.1;R587.1
- Published：2017
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王雨东,李传伟,何多芬,曾春雨,张小群,温春兰,杨成明.高血压伴或不伴2型糖尿病患者血压晨峰与冠脉病变严重程度的相关性[J].陆军军医大学学报(原第三军医大学学报),2017,39(01):89-94.

　Wang Yudong,Li Chuanwei,He Duofen,Zeng Chunyu,Zhang Xiaoqun,Wen Chunlan,Yang Chengming.Correlation of morning blood pressure surge with severity of coronary artery lesions in essential hypertension patients with or without type 2 diabetes mellitus[J].J Amry Med Univ (J Third Mil Med Univ),2017,39(01):89-94.
王雨东,李传伟,何多芬,曾春雨,张小群,温春兰,杨成明.高血压伴或不伴2型糖尿病患者血压晨峰与冠脉病变严重程度的相关性[J].陆军军医大学学报(原第三军医大学学报),2017,39(01):89-94. DOI：

　Wang Yudong,Li Chuanwei,He Duofen,Zeng Chunyu,Zhang Xiaoqun,Wen Chunlan,Yang Chengming.Correlation of morning blood pressure surge with severity of coronary artery lesions in essential hypertension patients with or without type 2 diabetes mellitus[J].J Amry Med Univ (J Third Mil Med Univ),2017,39(01):89-94. DOI：

摘要

目的探讨高血压伴或不伴2型糖尿病患者血压晨峰的患病特点及其与冠脉病变严重程度的相关性。方法选择2014年1月至2015年8月我科住院的高血压患者244例，其中男性118例，女性126例，年龄（64.7±11.5）岁，根据是否合并糖尿病及其动态血压监测结果将其分为4组：糖尿病晨峰组（D-S，36例）、糖尿病非晨峰组（D-nS，56例）、非糖尿病晨峰组（nD-S，72例）、非糖尿病非晨峰组（nD-nS，80例），入选的244例患者全部进行冠状动脉造影检查，分别比较4组患者冠状动脉病变程度。结果糖尿病晨峰组、糖尿病非晨峰组和非糖尿病晨峰组24 h平均收缩压、白天平均收缩压均高于非糖尿病非晨峰组（P0.05）；糖尿病晨峰组24 h平均舒张压、白天平均舒张压高于糖尿病非晨峰组、非糖尿病晨峰组和非糖尿病非晨峰组（P0.05）；晨峰组三支病变率、 C 型病变率及晨峰组 Gensini 总积分显著高于非晨峰组（P0.01）；Pearson相关分析显示，冠状动脉病变严重程度与年龄（r=0.786，P0.01）、BMI（r=0.284，P0.05）、空腹血糖（r=0.712，P0.05）、LDL-C（r=0.765，P0.05）、晨峰程度（r=0.852，P0.01）及24 h MSBP （r=0.804，P0.01）呈正相关；多元线性回归分析显示，年龄、空腹血糖、24 h平均收缩压及血压晨峰为冠状动脉病变严重程度独立危险因素。结论原发性高血压合并糖尿病患者血压晨峰是预测冠状动脉病变严重程度的独立危险因素，有效控制该类患者的晨峰血压及24 h长效平稳的降压可减少对靶器官的损害，降低心血管事件发生。

Abstract

Objective To explore the characteristics of morning blood pressure surge in the hypertensive patients combined with or without type 2 diabetes mellitus (T2DM) and its correlation with the severity of coronary artery lesions. Methods A total of 244 hypertensive inpatients (118 males and 126 females

at a mean age of 64.7±11.5) admitted in our department from January 2014 to August 2015 were recruited in this study. According to their morning blood pressure surge (MBPS) and complication with T2DM or not

the subjects were divided into 4 groups

that is

diabetes+MBPS group (D-S group

n=36)

diabetes+ non-MBPS group (D-nS group

n=56)

non-diabetic+ MBPS group (nD-S group

n=72)

and non-diabetic group+non-MBPS (nD-nS group

n=80). All 244 patients received coronary angiography

and the severity of coronary artery lesions were compared in the 4 groups. Results The 24-hour mean systolic blood pressure (24 h MSB) and day systolic blood pressure (dSBP) were significantly higher in the D-S group

D-nS group and nD-S group than the nD-nS group (P0.05). The 24-hour mean diastolic blood pressure (24 h MDBP) and day diastolic blood pressure (dDBP) were higher in the D-S group than the D-nS group

nD-S group and nD-nS group (P0.05). The MBPS groups had higher rates of 3-essel disease and type C lesion

and higher total Gensini scores (P0.01). Pearson correlation analysis showed that the severity of coronary lesions was positively correlated to age (r=0.786

P0.01)

body mass index (BMI

r=0.284

P0.05)

fasting blood glucose (FBG

r=0.712

P0.05)

low-density lipoprotein-cholesterol (LDL-C

r=0.765

P0.05)

MBPS (r=0.852

P0.01) and 24-hour mean systolic blood pressure (24 h MSBP

r=0.804

P0.01). Multivariate linear regression analysis indicated that FBG

24 h MSBP and MBPS were the independent risk factors for coronary lesions. Conclusion MBPS is an independent risk factor to predict the severity of coronary heart disease in essential hypertension patients with diabetes. Effective controlling of blood pressure and stably 24-hour long-term reducing blood pressure in this kind of patients can reduce target-organ damage and cardiovascular events in the patients

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Related Institution

Department of Immunology, Faculty of Pharmacy and Laboratory Medicine， Army Medical University （Third Military Medical University）

Department of Laboratory Animal Science， College of Basic Medical Sciences, Faculty of Pharmacy and Laboratory Medicine， Army Medical University （Third Military Medical University）

Department of Pharmaceutical Analysis, Faculty of Pharmacy and Laboratory Medicine， Army Medical University （Third Military Medical University）

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Department of Cardiology, Chongqing Institute of Cardiology, Institute of Surgery Research, Daping Hospital, Third Military Medical University

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