血压变异性与脑卒中-苏爱萍

20143111JNeurolNeurorehabilMarch2014Vol．11No．1【】1987—··2001272080bloodpressurevariabilityBPV。BPV1。AngloScandinaviancardiacoutcometrialASCOTBPV2。BPV。11．1BPVBPV。、2。BPV、。1．2BPVtimedomainanalysis。24h48SD24h48SD。frequencydomainanalysis。＜20～30s2～32①0.04～0.15Hz②0.15～0.30Hz③＜0．04Hz、。1．3BPVSD/SD、/SD24h/SD。coefficientofvaria-tionCVSD100%2。SD。variationindependentofmeanVIMSD/3。VIMBPV。22．1BPVBPV4。、、、、、。、、。。。。2．2BPVBPV。BPVBPV6060·81·20143111JNeurolNeurorehabilMarch2014Vol．11No．156。15～20mmHg10%～20%。BPV7。BPV18%38%8。、、2BPV。33．1。BPVIMT、。。BPV。3．2BPVSwedishTrialinOldPatientswithHypertensionSTOP9BPV。24hBPV。、、。122。BPVBPV。Sare10172224h。Giantin111BPVNIHSS。79224h12。①②BPV③BPVBPV。4115mmHg60%13。40～6920mmHg14。ＲCT15－17。BPVBPV。CCBβ17－19。BPV20。。BPV1。21389ＲCTBPVCCBBPVACEI、ⅡAＲBβP＜0.01BPV。ASCOT-BPLA2BPV。ValsartanAntihypertensiveLong-termUseEvaluationVALUE1CCB。5BPV。。·91·20143111JNeurolNeurorehabilMarch2014Vol．11No．1BPVBPVBPV。。。。。。。BPV。【】1ＲottweilerPM．Limitationsoftheblood-pressurehypothesisandimportanceofvariabilityinstabilityandepisodicalpertensionJ．Lancet2010375938－948．2ＲottweilerPMHowardSCDolandEetal．OnbehalfoftheAS-COTBPLAandMＲCTrialInvestigators．Effectsofβblockersandcalcium-channelblockersOI1within-individualvariabilityinblood-pressureandriskofstrokeJ．LancetNeurol20109469－480．3DolanEO'BrienE．BloodpressurevariabilityclarityforclinicalpracticeJ．Hypertension201056179－181．4TatascioreAＲendaGZimarinoMetal．Awakesystolicbloodpressurevariabilitycorrelateswithtarget-organdamageinhyperten-sivesubjectsJ．Hypertension200750325－332．5．J．20076370－373．6．J．20006531－533．7PepperellJC．StrokeandbloodpressurevariabilityJ．ClinSci200410727－28．8SinhaPKumarTDSinghNPetal．Seasonalvariationofbloodpressureinnormotensivefemalesaged18to40yearsinanurbanslumofDelhiIndiaJ．AsiaPacJPublicHealth201022134－135．9EkbomTDahlofBHanssonLetal．Thestrokepreventiveeffectinelderlyhypertensivescannotfullybeexplainedbythereductioninofficebloodpressure-insightsfromtheSwedishTrialinOldPatientswithHypertensionSTOP-HypertensionJ．BloodPressure19921168－172．10SayreGMAliMNailbrushAetal．Ｒelationshipbetweenhyper-acutebloodpressureandoutcomeafterischemicstrokedatafromtheVISTAcollaborationJ．Stroke2009402098－2103．11GentianVImplicitnessAFranchinAetal．OutcomeafteracuteischemicstrokeAISinolderpatientseffectsofageneurologicaldeficitseverityandbloodpressureBPvariationsJ．ArchGero-ntologicGeriatrician201152185－191．12KoYParkJHYangMHetal．ThesignificanceofbloodpressurevariabilityforthedevelopmentofhemorrhagictransformationinacuteischemicstrokeJ．Stroke2010412512－2518．13KengneAPPatelABarziFetal．FortheAsiaPacificCohortStudiesCollaboration．SystolicbloodpressurediabetesandtheriskofcardiovasculardiseasesintheAsia-PacificregionJ．JHypertens2007251205－1213．14ProspectiveStudiesCollaboration．Age-specificrelevanceofusualbloodpressuretovascularmortalityameta-analysisofindividualdataforonemillionadultsin61prospectivestudiesJ．Lancet20023601903－1913．15CollinsＲPetoＲMacmahonSetal．Bloodpressurestrokeandcoronaryheartdiseasepart2short-termreductionsinbloodpres-sureoverviewofrandomizeddrugtrialsintheirepidemiologicalcontextJ．Lancet1990335827－838．16BloodPressureLoweringTreatmentTrialists'Collaboration．Effectsofdifferentblood-pressure-loweringregimensonmajorcardiovasculareventsresultsofprospectively-designedoverviewsofrandomizedtrialsJ．Lancet20033621527－1535．17LawMＲMorrisJKWaldNJ．Useofbloodpressureloweringdrugsinthepreventionofcardiovasculardiseasemeta-analysisof147randomizedtrialsinthecontextofexpectationsfromprospectiveepidemiologicalstudiesJ．BMJ2009338b1665．18VerdecchiaPＲeboldiGAngeliFetal．Angiotensin-convertingenzymeinhibitorsandcalciumchannelblockersforcoronaryheartdiseaseandstrokepreventionJ．Hypertension200546386－392．19LindholmLHCarlbergBSamuelssonO．Shouldβblockersre-mainfirstchoiceinthetreatmentofprimaryhypertensionAmeta-analysisJ．Lancet20053661545－1553．20WebbAJFischerUMehtaZetal．Effectsofantihypertensivedrugclassoninterindividualvariationinbloodpressureandriskofstrokeasystematicreviewandmeta-analysisJ．Lancet2010375906－915．21PandianJDWongAALincolnDJetal．CircadianbloodpressurevariationafteracutestrokeJ．JClinNeuroscci200613558－562．【】2014－03－05·02·