老年人原发性高血压血压晨峰与心率变异性及心脏重构关系的探讨  

The relationship between morning blood pressure surge,heart rate variability and ventricular restoration in aged patients with primary hypertension.

作　　者：刘爱琴[1] 王岩[1] 杜巧[1] 黄建新[1] 张丽华[1] 封淑文[1] 

机构地区：[1]武警北京总队第二医院特检科,100037

出　　处：《武警医学》2010年第7期578-580,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨老年人原发性高血压血压晨峰(morning blood pressure surge,MBPS)与心率变异性(heart rate varia-bility,HRV)及心脏重构的关系。方法将明确诊断的老年人原发性高血压51例行动态血压监测、动态心电图监测(Holter)及超声心动图检查。根据MBPS程度是否超过50mmHg(1mmHg=0.133kPa)分为MBPS≥50mmHg组(A组)和MBPS<50mmHg组(B组),将两组患者的临床情况、HRV、左心室肥厚(left ventricular hypertrophy,LVH)及室性心律失常等指标进行比较。结果两组患者临床情况比较差异无统计学意义(P>0.05);A组低频功率/高频功率(LF/HF)比值、LF值高于B组(P<0.01和P<0.05);A组LVH及室性心律失常发生率高于B组(P<0.05)。结论老年人原发性高血压MBPS程度加剧与HRV及心脏重构有密切关系,是发生心脏事件的重要因素。Objectives To investigate the relationship between morning blood pressure surge （MBPS）, heart rate variability and ventricular restoration in aged patients with primary hypertension. Methods The data of 51 primary hypertension patients above 60 were collected. 24 h ambulatory blood pressure monitoring,24 h Holter and echocardiograms were measured in all the subjects. The biochemical parameters, such as blood lipids, were also tested. According to the morning blood pressure surge, the patients were divided into two groups（ A and B）. Group A had a MBPS higher than 50 mmHg（ n = 28） and group B lower than 50 mmHg（ n = 23 ）. Results There was no significant difference in clinical manifestations and biochemical parameters between the two groups （ P 〉 0.05 ）. The levels of LF/HF and LF in group A were higher than those in group B（ P 〈 0.01 and P 〈 0.05 ）. The rates of left ventricular hypertrophy and ventricular arrhythmia in group A were higher than those in group B （ P 〈 0.05 ）. Conclusions There are close relationships between morning blood pressure surge, heart rate variability and ventricular restoration in elder patients with primary hypertension. It may be an important factor of heart incidents.

关 键 词：高血压 晨峰现象 左心室肥厚 心率变异性 室性心律失常 

分 类 号：R54[医药卫生—心血管疾病] R540.4[医药卫生—内科学]