Objective To investigate the relationship of morning blood pressure surge with carotid intima-media thickness (CCA-IMT), carotid arteries plaque,brachial-ankle pulse wave velocity (baPWV) in patients with essential hypertension. Methods According to the results of 24 h ambulatory blood pressure monitoring, 128 patients were classified as the morning BP surge (MBPS group, n=49) or non-morning BP surge (NMBPS group, n=79). Patients underwent carotid ultrasonography, CCA-IMT and plaques were examined and the baPWV were also measured. Results In the MBPS group,the CCA-IMT [(1.12 + 0.21) mm vs (0.97 ±0.34)mm], the detection rate of plaques (43/49 vs 54/79 ), the average thickness of carotid arteries plaque [(1.35±0.33)mm vs (1.21 ±0.24)mm], the baPWV [(1629.9+ 223.5)cm/s vs (1507.6 +247.6)cm/s] were higher than those in NMBPS group (P<0.05 or 0.01). Multivariate logistic regression analysis showed that MBPS was independent risk factor of increased CCA-IMT (OR=1.73, 95%CI: 0.97~4.28) and baPWV (OR=2.26, 95%CI:1.84~6.78, P<0.01). Conclusion Morning blood pressure surge in patients with essential hypertension is associated with carotid atherosclerosis and damage of aortic elasticity.%目的 探讨原发性高血压人群血压晨峰现象与颈动脉内膜中层厚度(CCA-IMT)、颈动脉斑块以及肱-踝动脉脉搏波速度(baPWV)的相关性.方法 对入选的原发性高血压患者128例进行24h动态血压监测,根据结果分为晨峰组49例和非晨峰组79例,两组均进行颈动脉超声检查,测量CCA-IMT和颈动脉斑块,同时进行baPWV检测,比较两组CCA-IMT、颈动脉斑块以及baPWV的差异.结果 晨峰组的CCA-IMT(1.12±0.21)mm、斑块检出率87.76%、斑块的平均厚度(1.35±0.33)mm、baPWV(1629.9±223.5)cm/s,均高于非晨峰组[(0.97±0.34)mm、68.35%、(1.21±0.24)mm、(1507.6s±247.6)cm/s](P＜0.05或0.01).多元Logistic逐步回归分析结果显示,仅血压晨峰为CCA-IMT及baPWV值增大的独立危险因素,OR值及95%CI分别为:1.73(0.97～4.28)和2.26(1.84～6.78)(均P＜0.01).结论 血压晨峰可能与动脉粥样硬化和动脉弹性功能减退有关.
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