高龄老年高血压患者夜间血压与靶器官损害相关性研究  

Correlation between nocturnal blood pressure and target organ damage in senior hypertensive patients

作　　者：赵鑫[1] 包蓓[1] 曲毅[1] 方宁远[1] 

机构地区：[1]上海交通大学医学院附属仁济医院老年病科,200127

出　　处：《老年医学与保健》2008年第5期283-287,共5页Geriatrics & Health Care

摘　　要：目的探讨高龄老年高血压患者夜间血压控制水平与靶器官损害之间的关系及其干预策略。方法2005年1月至2007年12月仁济医院老年病科就诊208例高龄老年高血压患者(年龄≥80岁),根据动态血压检测结果分为单纯夜间血压控制不良组(n=102)和全天血压控制均在正常范围组(n=106),对患者的临床资料、生化指标、心脏彩超和颈动脉B超检查结果及降压治疗方案进行分析。结果两组年龄、性别、血肌酐、血尿素氮、尿酸水平的差异均无统计学意义。两组总胆固醇、甘油三酯、空腹血糖、左室相关参数、颈动脉结构血流参数及斑块情况的差异有统计学意义(P<0.05);CCB+ACEI/ARB组合比利尿剂+ACEI/ARB组合,在高龄老年高血压患者夜间血压水平控制方面更为有效(P<0.001),结论高龄老年高血压患者夜间血压水平与左心室肥厚、颈动脉斑块(P<0.05)正相关;CCB+ACEI/ARB药物组合在高龄老年高血压患者夜间血压水平控制效果较好。Objectives To investigate the correlation between nocturnal BP control and target organ damage in senior hypertensive patients, and discuss intervention strategies. Methods According to the result of dynamic BP monitoring, 208 hypertensive patients older than 80 years were divided into two groups： group A, where the patients （n= 102） had simple uncontrollable nocturnal BP, and group B, where the patients （n= 106） had controllable BP throughout the day. Clinical data, biochemical indexes, ultrasonographic cardiographic and carotid artery B-mode ultrasonographic findings, and the antihypertensive protocols of the patients were analyzed. Results There were significant differences in serum total cholesterol, triglyceride, fasting blood glucose, LV related parameters, IMT in normal carotid artery and branch of carotid artery between the two groups （P〈0.05）. CCB＋ACEI/ARB combination was more convenient and effective for controlling nocturnal BP in senior patients as compared with combination use of diuretics ＋ ACEI/ARB （P〈0.001）. Conclusion There is a significant positive correlation between the level of nocturnal BP and LV hypertrophy or carotid plaques. Combination of CCB and ACEI/ARB seems more effective for controlling nocturnal BP in senior hypertensive patients.

关 键 词：高血压 老年人 80以上 血压 血压测定 肥大 左心室 颈动脉 血管紧张素转换酶抑制剂 血管紧张素Ⅱ受体拮抗剂 

分 类 号：R544.1[医药卫生—心血管疾病]