老年高血压患者血压昼夜节律紊乱对心率的影响  

Effects of circadian rhythm disorders of blood pressure on heart rate in elderly hypertensive patients

作　　者：缪京莉[1] 周云飞[1] 尹巧香[1] 张晓艳[1] 李军杰[1] 

机构地区：[1]解放军空军总医院干部病房,北京100142

出　　处：《中国临床保健杂志》2013年第6期569-572,共4页Chinese Journal of Clinical Healthcare

摘　　要：目的探讨老年高血压患者血压昼夜节律紊乱对心率的影响。方法选择降压治疗期间诊室血压正常的200例老年单纯收缩期高血压患者,根据动态血压检查结果,分为杓型组56例,非杓型组80例,反杓型组64例,选择健康者32例做为对照组。全部患者进行24 h动态心电图检查,比较各组与对照组24 h、白昼和夜间的心率水平、心率变异性,分析血压与心率的相关性。结果心率在非杓型组和反杓型组快于杓型组或对照组(P<0.01、P<0.05);SDANN、SDNN、rMSSD、PNN50在反杓型组显著降低(P<0.01、P<0.05);白昼心率增快与白昼平均收缩压和舒张压增高呈正相关(P<0.05),夜间心率增快与夜间平均收缩压增高呈正相关(P<0.05)。结论血压增高与心率增快具有相关性,血压昼夜节律紊乱可使心率增快,心率变异性下降。Objective To investigate the influence of circadian rhythm disorders of blood pressure on heart rate in elderly hypertensive patients.Methods 200 elderly patients with isolated systolic hypertension were selected and divided into three groups [dipper type (n =56),non-dipper type (n =80)and reverse-dipper type (n =64)] according to the ambulatory blood pressure,32 healthy individuals were recruited as control group.All the patients and healthy subjects were submitted to 24-h ambulatory blood pressure monitoring.The 24 h daytime and nighttime heart rate and heart rate variability were recorded.Results The heart rate of hypertensive patients with non-dippers and re-verse-dipper was significantly higher than that of patients with dipper and healthy subjects (P <0.01,P <0.05);The values of SDANN、SDNN、rMSSD、PNN50D were significantly lower in the reverse-dippers type group(P <0.01, P <0.05)compared with those of dippertype and non-dipper type group,the heart rate was positively correlated to the average systolic and diastolic blood pressure during the daytime and nighttime (P <0.05).Conclusion The circadi-an rhythm disorders of blood pressure is associated with higher heart rate and lower heart rate variability.

关 键 词：高血压 昼夜节律 心率 老年人 

分 类 号：R544.1[医药卫生—心血管疾病]