老年原发性高血压不同心血管危险分层病人维生素D与血压变异性的相关性  

Relationship between vitamin D and blood pressure variability in elderly patients with essential hypertension with stratified cardiovascular risk

作　　者：邵伟华[1] 苑晓烨[1] 吕彩霞[1] 王娜 SHAO Wei-hua;YUAN Xiao-ye;LV Cai-xia;WANG Na(Second Department of Geriatrics, Hebei General Hospital, Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院老年病二科

出　　处：《实用老年医学》2019年第9期895-898,共4页Practical Geriatrics

基　　金：河北省卫生和计划生育委员会科研基金项目(20180201);河北省自然科学基金资助项目(H2016307015)

摘　　要：目的探讨老年原发性高血压不同心血管危险分层病人血清维生素D水平的差异及与血压变异性(BPV)的相关性。方法选取我院符合纳入标准的老年原发性高血压病人90例,按照原发性高血压心血管危险分层标准分为中危组25例,高危组27组,很高危组38例。选取同期健康体检者30例作为对照组。所有受试者均测定血清25羟维生素D 3[25(OH)D 3]水平及动态血压,以变异系数(CV)表示BPV,观察25(OH)D 3水平与老年高血压心血管危险分层及BPV的相关性。结果老年高血压病人中危组、高危组、很高危组的血清25(OH)D 3水平均低于健康对照组( P均<0.05),且很高危组、高危组、中危组的血清25(OH)D 3水平依次降低,两两比较差异均有统计学意义( P 均<0.05)。中危组、高危组、很高危组的24 h收缩压(24hSBP)、24hSBP变异系数(24hSBP-CV)、24 h舒张压变异系数(24hDBP-CV)、日间收缩压变异系数(dSBP-CV)、日间舒张压变异系数(dDBP-CV)、夜间收缩压变异系数(nSBP-CV)、夜间舒张压变异系数(nDBP-CV)较对照组明显升高,差异有统计学意义( P 均<0.05),中危组、高危组、很高危组上述指标依次升高,两两比较差异有统计学意义( P均<0.05)。血清25(OH)D 3与24hSBP、24hSBP-CV、24hDBP-CV均呈负相关( r =-0.312,-0.381,-0.421, P<0.05)。 结论维生素D水平与老年原发性高血压的发病及其心血管危险分层相关,且与BPV呈负相关,维生素D可作为老年高血压病情的一个较可靠的预测因子。Objective To observe the serum levels of vitamin D in the elderly patients with essential hypertension(EH) presenting with different cardiovascular risk stratification and the correlation with blood pressure variability (BPV). Methods A total of 90 elderly patients with essential hypertension in our hospital who met the inclusion criteria were divided into three groups according to the cardiovascular risk stratification criteria for EH, with 25 patients in the middle-risk group, 27 patients in the high-risk group and 38 patients in the very high-risk group. And another 30 healthy elderly were selected as the control group. Serum level of vitamin D and ambulatory blood pressure were measured in all subjects. BPV was expressed as a coefficient of variation (CV). The correlation between vitamin D and cardiovascular risk stratification and BPV was observed. Results The serum level of 25(OH)D 3 in the middle-risk group, high-risk group, and very high-risk group was lower than that in the control group ( P < 0.05). The serum levels of 25(OH)D 3 in the very high-risk group, high-risk group and middle-risk group were decreased in turn, and the difference between the three groups was statistically significant ( P < 0.05). The levels of 24hSBP, 24hSBP-CV, dSBP-CV, nSBP-CV, 24hDBP-CV, dDBP-CV, and nDBP-CV in the middle-risk group, high-risk group, and very high-risk group were significantly higher than those in the control group ( P < 0.05). The above indicators in the middle-risk group, high-risk group, high-risk group increased in turn, and the difference between the three groups was statistically significant ( P < 0.05). The serum level of 25(OH)D 3 and 24hSBP, 24hSBP-CV, 24hDBP-CV were negatively correlated ( r =-0.312,-0.381,-0.421, P < 0.05). Conclusions Vitamin D deficiency is associated with the onset and cardiovascular risk stratification of EH in the elderly. It is negatively correlated with BPV and can be used as a reliable predictor of cardiovascular severity in the elderly hypertensive patients.

关 键 词：原发性高血压 老年人 心血管危险分层 维生素D 血压变异性 

分 类 号：R544.1[医药卫生—心血管疾病]