高龄老年高血压患者血压昼夜节律和脉压变化特征探讨  

Investigation of the diurnal rhythm of blood pressure and pulse pressure in very elderly patients with hypertension

作　　者：李鑫[1] 徐新献[2] 周婧[2] 姚武位[2] 田绿[2] 窦娟[2] 潘怡[2] 余朝萍 

机构地区：[1]重庆市第五人民医院神经内科,重庆400062 [2]重庆市第五人民医院老年病科,重庆400062

出　　处：《中国实用神经疾病杂志》2016年第11期17-19,共3页Chinese Journal of Practical Nervous Diseases

基　　金：重庆市南岸区卫生局医学科研计划项目(项目编号[2014]263号)

摘　　要：目的探讨高龄老年高血压患者血压昼夜节律和脉压变化的特点。方法将老年高血压患者346例按年龄分为2组：老年高血压组（A组）186例,年龄60~79岁;高龄老年高血压组（B组）160例,年龄80-99岁。分析2组患者动态血压参数、动态血压昼夜节律异常发生率。结果24h平均舒张压（24hDBP）高龄老年高血压组低于老年高血压组（P〈0.001）。老年高血压组和高龄老年高血压组24h动态脉压（24hAPP）分别为（62.06±11.79）和（66.73±11.45）mmHg。日间平均压（dABP）老年高血压组高于高龄老年高血压组（P〈0.01）。24hAPP老年高血压组低于高龄老年高血压组（P〈0.001）。老年高血压组和高龄老年高血压组血压昼夜节律异常率分别为82.80%和90.63%。结论老年高血压患者随着年龄的增大,24hDBP呈现降低趋势,24hAPP呈现增高趋势。老年高血压患者血压昼夜节律特征多数表现为非杓型和反杓型血压,且多数血压昼夜节律消失。随增龄变化老年高血压患者昼夜节律异常率增高,增龄是血压昼夜节律消失的一个重要因素。Objective To investigate the characteristic of the diurnal rhythm of blood pressure and pulse pressure in the very elderly patients with hypertension.Methods Totally 346 elderly patients with hypertension were divided into two groups according to their ages：186patients in elderly hypertension group（group A,aged from 60 to 79）,160 patients in very elderly hypertension group（group B,aged from 80 to 99）.The parameters of abnormal blood pressure and incidence of abnormal blood pressure on diurnal rhythm were analyzed in the two groups.Results 24-hour average diastolic pressure（24h-DBP）in very elderly hypertension group was lower than those in elderly hypertension group（P〈0.01）.The 24 hambulatory pulse pressure（24hAPP）was（62.06±11.79）mmHg（elderly hypertension group）,（66.73±11.45）mmHg（very elderly hypertension group）,respectively.Daytime average blood pressure（dABP）in elderly hypertension group was higher than that of very elderly hypertension group（P〈0.01）.The 24 hambulatory pulse pressure（24h-APP）in elderly hypertension group was lower than that in very elderly hypertension group（P〈0.001）.The rate of abnormal of diurnal rhythm of blood pressure was 82.80%（elderly hypertension group）,90.63%（very elderly hypertension group）,respectively.Conclusion 24-hour average diastolic pressure（24hDBP）is decreasing trend in elderly patients with hypertension with the increase age.24 hambulatory pulse pressure（24h-APP）is increased trend in elderly patients with hypertension with the increase age.Non-dipper and reverse dipper blood pressure is more commonly existed with the characteristic of diurnal rhythm of blood pressure in elderly hypertensive patients.The diurnal rhythm of blood pressure is disappeared with the diurnal rhythm of blood pressure in elderly hypertensive patients.Abnormal rate of abnormal of diurnal rhythm of blood pressure is variational along with the increase age.The increasing age is an important factor of disappeared with the diurnal

关 键 词：老年人 高血压 昼夜节律 动态血压监测 

分 类 号：R544.1[医药卫生—心血管疾病]