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目的探讨门诊无心血管病非卧床者臂间血压差异(IAD)及其相关的影响因素。方法入选2015年3-9月门诊无心血管病且年龄≥40岁就诊者680人,用欧姆龙HEM-1020型自动电子血压计同时测量双臂血压。IAD表示为绝对差异[|右臂血压(R)-左臂血压(L)|:(|R-L|)],比较男女间IAD的差异,并分析相关的影响因素。结果男性和女性臂间收缩压差异(sIAD)分别为(3.10±1.24)和(2.76±1.47)mm Hg,差异无统计学意义(P=0.25)。男性和女性臂间舒张压差异(dIAD)分别为(2.38±1.16)和(2.22±1.34)mm Hg,差异无统计学意义(P=0.29)。男性患者中,84.0%的sIAD<6 mm Hg,98.2%<10 mm Hg;96.6%的男性患者dIAD<6 mm Hg。88.7%的女性患者sIAD<6mm Hg,92.0%女性患者dIAD<6mm Hg。在男性中,sIAD与10年Framingham心血管病风险和高血压相关[Framingham心血管病风险≥10%:(3.53±1.88)比Framingham心血管病风险<10%:(2.90±1.13)mm Hg;高血压(3.34±1.28)比正常血压(2.92±1.20)mm Hg;均P<0.05]。在女性中,高血压组sIAD高于正常血压组[(3.16±1.81)比(2.44±1.73)mm Hg;P<0.05]。结论大部分门诊无心血管病非卧床者的sIAD<10mm Hg,dIAD<6mm Hg。
Objective To explore the difference of inter-arm blood pressure (IAD) and its influencing factors in outpatients with cardiovascular disease without bed rest. METHODS: From March to September 2015, 680 outpatients with no cardiovascular disease and ≥40 years of age were enrolled in the study. Blood pressure was measured simultaneously with OMRON HEM-1020 automatic electronic sphygmomanometer. IAD was expressed as the absolute difference [| right arm blood pressure (R) - left arm blood pressure (L) |: (| R-L |)], comparing the difference between male and female IAD and analyzing the related influencing factors. Results The differences in systolic pressure (sIAD) between male and female arms were (3.10 ± 1.24) and (2.76 ± 1.47) mm Hg, respectively, with no significant difference (P = 0.25). The differences in dIAD between male and female arms were (2.38 ± 1.16) and (2.22 ± 1.34) mm Hg, respectively, with no significant difference (P = 0.29). Among male patients, 84.0% had sIAD <6 mm Hg, 98.2% <10 mm Hg; and 96.6% had dIAD <6 mm Hg for men. 88.7% of female patients had sIAD <6 mm Hg and 92.0% of female patients had dIAD <6 mm Hg. In men, sIAD is associated with 10-year Framingham cardiovascular risk and hypertension [Framingham cardiovascular disease ≥10%: (3.53 ± 1.88) vs Framingham cardiovascular risk <10% :( 2.90 ± 1.13) mm Hg; Hypertension (3.34 ± 1.28) than normal blood pressure (2.92 ± 1.20) mm Hg; all P <0.05]. In women, sIAD was higher in the hypertensive group than in the normotensive group (3.16 ± 1.81 vs 2.44 ± 1.73 mm Hg; P <0.05). Conclusions Most outpatients with cardiovascular disease who are not bedridden have sIAD <10 mm Hg and dIAD <6 mm Hg.