冠心病合并高血压的老年患者血压控制中J形曲线分析  

J Curve in blood pressure control of elderly patients with coronary heart disease and hypertension

作　　者：朱敏洁[1] 周文锐[1] 李琛 

机构地区：[1]同济大学附属杨浦医院老年二科,上海200092 [2]同济大学附属杨浦医院全科医学科/全科医学教研室,上海200092

出　　处：《临床和实验医学杂志》2015年第22期1865-1867,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的分析冠心病合并高血压的老年患者血压控制中J形曲线。方法选择老年冠心病合并高血压的患者共315例,按患者不同的收缩压控制水平,将患者分为5组：A组51例,收缩压〈120 mm Hg;B组68例,收缩压120～129 mm Hg;C组75例,收缩压130～139 mm Hg;D组62例,收缩压140～149 mm Hg;E组58例,收缩压控制≥150 mmHg。随访各组心脑血管事件发生情况,并比较。结果随访期间共发现心脑血管事件150起。在调整了年龄、BMI、舒张压之后,发现在140 mm Hg以上时,心脑血管事件发生率明显较高;收缩压控制在120～130 mm Hg时,发生心脑血管意外的风险最小,而当收缩压控制在收缩压〈120 mm Hg时,心脑血管事件发生率反而有所升高。结论老年冠心病合并高血压的患者降压控制中存在＂J形曲线＂现象,应合理控制血压。Objective To investigate J Curve in blood pressure control of elderly patients with coronary heart disease and hypertension.Methods A total of 315 cases with coronary heart disease and hypertension were collected,according to the levels of systolic blood pressure control,patients were divided into 5 group： group A with 51 cases,systolic blood pressure 〈120 mm Hg; group B with 68 cases,systolic blood pressure 120 ～ 129 mm Hg; group C with 75 patients,systolic blood pressure 130 ～ 139 mm Hg; group D with 62 patients,systolic blood pressure 140～ 149 mm Hg; group E with 58 cases,systolic blood pressure control ≥150 mm Hg. Cardiovascular events in each group were followed- up and compared. Results A total of 150 cardiovascular events were found during follow- up. After adjusting for age,BMI and diastolic blood pressure,when systolic blood pressure was controlled at more than 140 mm Hg,cardiovascular events rate was significantly higher; when controlled at 120 ～130 mm Hg,cardiovascular events rate was minimized; and when controlled at 120 mm Hg,cardiovascular events rate was increased instead.Conclusion In elderly patients with coronary heart disease and hypertension, ＂ J- curve＂ phenomenon exists. We should be reasonable in controlling blood pressure.

关 键 词：高血压 冠心病 收缩压 J形曲线 

分 类 号：R544.1[医药卫生—心血管疾病] R541.4[医药卫生—内科学]