Myocardial perfusion pressure in patients with hypertension and coronary artery disease

医学 心脏病学 内科学 部分流量储备 冠状动脉疾病 糖尿病 心绞痛 血压 狭窄 原发性高血压 心肌梗塞 冠状动脉造影 内分泌学
作者
Simon W. Rabkin,Aiza Waheed,Rohan Poulter,David Wood
出处
期刊:Journal of Hypertension [Lippincott Williams & Wilkins]
卷期号:31 (5): 975-982 被引量:33
标识
DOI:10.1097/hjh.0b013e32835e831c
摘要

The target blood pressure (BP) in patients with hypertension and coronary artery disease (CAD) has been controversial. Whether patients with both diabetes mellitus and CAD should follow targets for either diabetes mellitus or CAD is uncertain. Focusing only on one determinant of coronary blood flow (CBF) - myocardial perfusion pressure (MPP) - coronary BP in patients with hypertension was used to estimate the impact of setting BP targets.A consecutive series of 101 patients referred for coronary angiography for stable angina pectoris or possible CAD had BP measurements proximal and distal to coronary artery stenosis. Fractional flow reserve (FFR) was measured from adenosine-induced maximal hyperemia. DBP after the coronary stenosis was the MPP. The most severe coronary lesion for each person was selected.Of 101 patients, 65.0 ± 10.6 years (mean ± SD), there were 69 with hypertension and 33 with diabetes mellitus of whom 25 had diabetes mellitus along with hypertension. In hypertension, FFR was 0.83 ± 0.08, range from 0.49 to 0.97, with 40% having FFR less than 0.8. There was a significant linear relationship between systemic DBP and MPP. CBF approximates zero with MMP of 50 mmHg under resting conditions and 40 mmHg with coronary vasodilatation. On the basis of our findings in hypertension, if DBP were 80, 70, 65 and 60 mmHg, 1.4, 7.1, 15.7 and 54.3%, respectively, of patients would have an MPP of less than 50 mmHg. The values were similar for patients with diabetes mellitus.In our patient group with moderate coronary artery stenosis, a target DBP of 60 mmHg or less would be associated with unacceptably low MPPs. In patients with diabetes mellitus, the presence and severity of CAD stenosis may be more important factor in setting BP targets for treatment of hypertension. Because the degree of coronary stenosis is unknown in most patients with hypertension and CAD, guideline recommendations should consider cautioning clinicians about the potential for myocardial ischaemia at low DBP.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
隐形曼青应助able采纳,获得10
3秒前
咸鱼已躺平完成签到,获得积分10
5秒前
诡异的饭团完成签到,获得积分10
6秒前
anan完成签到 ,获得积分10
7秒前
常绝山完成签到 ,获得积分10
7秒前
幽默皮皮虾完成签到,获得积分10
7秒前
易止完成签到 ,获得积分10
7秒前
just完成签到,获得积分10
8秒前
10秒前
Disguise完成签到,获得积分10
10秒前
Young4399完成签到 ,获得积分10
10秒前
火星上宛秋完成签到 ,获得积分10
11秒前
11秒前
11秒前
量子星尘发布了新的文献求助10
11秒前
szh123完成签到 ,获得积分10
12秒前
Luke发布了新的文献求助10
14秒前
mauve完成签到 ,获得积分10
14秒前
丽丽完成签到,获得积分10
18秒前
敏感笑槐完成签到 ,获得积分10
19秒前
Luke完成签到,获得积分10
19秒前
得鹿梦鱼完成签到,获得积分10
20秒前
嗝嗝完成签到,获得积分10
22秒前
Perry应助科研通管家采纳,获得30
22秒前
22秒前
今后应助水晶茶杯采纳,获得10
22秒前
peterlzb1234567完成签到,获得积分10
24秒前
natsu401完成签到 ,获得积分10
27秒前
mmddlj完成签到 ,获得积分10
27秒前
健康的雁凡完成签到,获得积分10
27秒前
稳重完成签到 ,获得积分10
29秒前
32秒前
haiqi完成签到,获得积分20
36秒前
白智妍发布了新的文献求助10
37秒前
王叮叮完成签到,获得积分10
38秒前
jeronimo完成签到,获得积分10
39秒前
39秒前
pcr163应助大橙子采纳,获得150
42秒前
李燕发布了新的文献求助10
44秒前
道友等等我完成签到,获得积分0
44秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038184
求助须知:如何正确求助?哪些是违规求助? 3575908
关于积分的说明 11373872
捐赠科研通 3305715
什么是DOI,文献DOI怎么找? 1819255
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022