老年高血压动态血压指标与射血分数保留或降低心力衰竭的相关性研究  

Relationship between Ambulatory Blood Pressure and Heart Failure with Preserved or Reduced Ejection Fraction in Older Patients with Hypertension

作　　者：王玉珍[1] 王秀艳[1] 刘春红[1] Wang Yuzhen;Wang Xiuyan;Liu Chunhong(Department of Cadre Ward, Kailuan General Hospital, Tangshan 063000, China)

机构地区：[1]开滦总医院干部病房

出　　处：《国际老年医学杂志》2019年第3期158-161,共4页International Journal of Geriatrics

摘　　要：目的探讨老年高血压患者动态血压指标与射血分数保留或降低心力衰竭(HF)的相关性。方法选取2013年5月~2015年12月于我院干部病房住院的老年高血压患者159例,根据患者是否合并射血分数保留或降低心力衰竭分为心力衰竭组(HF组)和无心力衰竭组(NHF组),比较分析两组患者的临床资料和动态血压监测评估指标的差异性。结果老年高血压多表现为夜间血压增高,晨峰现象明显。HF组患者的年龄、性别、舒张压(DBP)、空腹血糖(FBG)、甘油三酯(TG)与NHF组无统计学差异(P>0.05),而收缩压(SBP)、脉压差、单纯收缩期高血压(ISH)以及血清尿酸(SUA)均较NHF组显著升高,差异有统计学意义(P<0.05)。HF组的24h平均收缩压、血压晨峰、昼夜血压节律(非杓型)均高于NHF组,差异有统计学意义(P<0.05)。Pearson相关分析发现EF与24h平均收缩压呈负相关(r=-0.28,P=0.013),与SBP呈负相关(r=-0.32,P=0.01)。结论24h平均收缩压、SBP、脉压差、ISH、血压晨峰、昼夜血压节律(非杓型)等动态血压监测指标和SUA是影响合并射血分数保留或降低心力衰竭老年高血压患者的主要危险因素。Objective To investigate the correlation between ambulatory blood pressure ( ABP) and heart failure with preserved ejection fraction ( HFpEF) or reduced ejection fraction ( HFrEF) in older patients with hypertension. Methods A total of 159 patients with hypertension between May 2013 and December 2015 were recruited. The patients were divided into heart failure (HF group) and non-heart failure group ( NHF group). The clinical data and ambulatory blood pressure parameters in two groups were compared. Results Older patients with hypertension demonstrated nocturnal hypertension and morning blood pressure surge. There were no significant differences in age, sex, diastolic blood pressure ( DBP), fasting blood glucose ( FBG ), triglyceride (TG) between the two group (P>0.05). However, systolic blood pressure (SBP), pulse pressure, isolated systolic hypertension (ISH) and serum uric acid (SUA) in HF group were significantly higher than those in NHF group (P<0.05). Mean SBP, morning blood pressure peak and circadian blood pressure rhythm in HF group were higher than those in NHF group (P< 0.05 ). Pearson correlation analysis showed that EF was negatively correlated with mean SBP in 24 hours (r =-0.28, P= 0.013 ) and SBP (r =-0.32,P = 0.01). Conclusion The 24-hour mean SBP, SBP, pulse pressure, ISH, morning peak, circadian blood pressure rhythm ( non-dipper type) and SUA are the major risk factors in older hypertensive patients with HFpEF or HFrEF.

关 键 词：老年 高血压 动态血压监测 心力衰竭 靶器官损害 

分 类 号：R544.1[医药卫生—心血管疾病] R541.6[医药卫生—内科学]