老年原发性高血压患者血压变异性的相关危险因素  

Risk factors correlated with blood pressure variability in elderly patients with essential hypertension

作　　者：司徒薇薇[1,2] 汪海娅[1] 徐晓颖[1] 金贤[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科,上海200001 [2]上海市医学会

出　　处：《上海医学》2013年第4期346-349,共4页Shanghai Medical Journal

摘　　要：目的分析老年原发性高血压患者血压变异性(BPV)与各种危险因素和靶器官损害(TOD)的相关性。方法对176例老年原发性高血压病患者进行动态血压监测,根据24h收缩压(SBP)的变异性(24hSBPV)递减顺序分入24hSBPV高组(88例)和24hSBPV低组(88例),分析两组的临床资料、生化指标、颈动脉超声、超声心动图、尿微量白蛋白检查结果。结果 Logistic多元回归分析显示,总胆固醇(RR=27.30,95%CI为1.237～602.73)、空腹血糖(RR=1.724,95%CI为1.003～2.962)和空腹胰岛素(RR=1.396,95%CI为1.088～1.791)与24hSBPV呈正相关(P值分别<0.05、0.01)。24hSBPV高组的左心室质量指数显著高于24hSBPV低组(P<0.05)。结论总胆固醇、空腹血糖、空腹胰岛素水平与24hSBPV相关。24hSBPV增大与老年原发性高血压患者左心室肥厚相关。Objective To explore the correlations between blood pressure variability （BPV） and target organ damage （TOD） in elderly patients with essential hypertension. Methods A total of 176 elderly patients with essential hypertension were enrolled in the study. Ambulatory blood pressure monitoring was performed in all the patients. According to the decrease of standard deviation of 24h systolic blood pressure variability （24hSBPV〉, the subjects were divided into 24 h-high-SBPV group （n = 88） and 24 h-low-SBPV group in= 88）. Clinical data, biochemical indicators, carotid ultrasound, echocardiogram and urine microalbumin were evaluated. Results Logistic multiple regression analysis showed that 24 h SBPV was positively correlated with total cholesterol （ RR = 27.30, 95 % CI .. 1. 237 - 602.73 ）, fasting plasma glucose （RR= 1. 724, 95% CI： 1. 003-2.962）, and fasting insulin levels （RR= 1. 396, 95% Cl= 1. 088- 1.791 ） in elderly patients with essential hypertension（ P^0.05, 0.01 ）. Left ventricular mass index in 24 h- high-SBPV group was significantly higher than that in 24 h-low-SBPV group （ P^0. 05）. Conclusion Total cholesterol, fasting plasma glucose, and fasting insulin levels are related to 24hBPV in elderly patients with essential hypertension. Higher 24hBPV seems to be correlated with left ventricular hypertrophy in elderly patients with essential hypertension.

关 键 词：老年 原发性高血压 血压变异 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病]