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目的调查社区人群高血压和血管内皮功能指标的现状,进一步分析高血压的危险因素,探讨高血压患者血管紧张紊Ⅱ、前列环素和一氧化氮水平的变化。方法整群抽取社区汉族成年居民1134人,测量其身高、体重、腰围、臀围和血压,并记录病史资料。用镉还原法检测血清一氧化氮水平,用放射免疫分析法检测血浆血管紧张素Ⅱ和前列环素的浓度。所有数据用SPSS 13.0软件进行统计分析。结果目标人群中高血压患者占44.5%,标准化患病率为15.3%。随着年龄的增加高血压患病率逐渐升高。超重和肥胖是高血压患病的独立危险因素,性别、吸烟史和饮酒史没有进入高血压的logistic回归方程。高血压三组的血管紧张素Ⅱ水平都比正常组低,其中以已控制血压组最低;已控制血压组和已知高血压未控制组的前列环素和一氧化氮水平较正常组升高,差异有统计学意义。而新查出高血压组前列环素和一氧化氮水平升高的差异无统计学意义。结论高血压的患病率呈逐年升高的趋势,控制体重将有利于高血压的预防。推测:患高血压后,人体内肾素-血管紧张素-醛固酮系统的负反馈调节机制依然存在,这一假想可能有助于高血压发病机制的进一步研究。
Objective To investigate the status of hypertension and endothelial function in community population, further analyze the risk factors of hypertension, and investigate the changes of the levels of angiotensin Ⅱ, prostacyclin and nitric oxide in hypertensive patients. Methods A total of 1134 adult residents of the Han nationality in the community were sampled and their height, weight, waist circumference, hip circumference and blood pressure were measured. The medical history data were recorded. Serum nitric oxide levels were measured by cadmium reduction assay, and plasma concentrations of angiotensin II and prostacyclin were measured by radioimmunoassay. All data were analyzed by SPSS 13.0 software. Results The target population was 44.5% with hypertension and the standardized prevalence rate was 15.3%. The prevalence of hypertension increases with age. Overweight and obesity were independent risk factors for hypertension, and logistic regression equations for hypertension, smoking history, and alcohol consumption were not entered. The levels of angiotensin Ⅱ in the three groups were lower than those in the normal group, of which the lowest was in the controlled blood pressure group. The levels of prostacyclin and nitric oxide in the controlled blood pressure group and the uncontrolled hypertension group were higher than those in the normal group ,The difference was statistically significant. The newly detected hypertension group prostacyclin and nitric oxide levels increased no significant difference. Conclusion The prevalence of hypertension is increasing year by year, and weight control will be helpful for the prevention of hypertension. Presumably, the negative feedback regulation mechanism of renin-angiotensin-aldosterone system still exists after suffering from hypertension, which may be helpful for the further study on the pathogenesis of hypertension.