不同年龄高血压病人血压特点分析  

Analysis of Blood Pressure Characteristics in Patients with Hypertension of Different Ages

作　　者：童艳杰 樊小农[1,2,3,4] 刘琪 余亮 史舒文 TONG Yanjie;FAN Xiaonong;LIU Qi;YU Liang;SHI Shuwen(First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China)

机构地区：[1]天津中医药大学第一附属医院,天津300381 [2]国家中医针灸临床医学研究中心,天津300381 [3]天津市针灸研究所,天津300381 [4]天津市针灸学重点实验室,天津300381 [5]天津市中医药研究院附属医院

出　　处：《中西医结合心脑血管病杂志》2023年第1期10-15,共6页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家科技支撑计划课题项目(No.2013BAI13B031);天津市科技计划项目(No.16ZXMJSY00040)。

摘　　要：目的:分析不同年龄原发性高血压病人血压特点,为高血压的精准化管理提供指导。方法:回顾性分析2014年5月—2019年4月于天津中医药大学第一附属医院门诊招募的504例原发性高血压病人的临床资料。根据年龄将病人分为青中年组(年龄<60岁)和老年组(年龄≥60岁),进行动态血压监测,分析其24 h、日间、夜间的血压均值,以及血压类型分布、脉压、血压变异性、血压节律特点。结果:(1)老年组病程较长(P<0.05),不吸烟病人较多(P<0.05),服药率更高(P<0.05);青中年组BMI较大(P<0.05),受教育水平较高(P<0.05)。(2)两组动态血压均值均普遍超出诊断标准,尤以夜间血压明显。青中年组舒张压升高的病人数以及舒张压水平均高于老年组(P<0.05);两组动态收缩压水平比较差异无统计学意义(P>0.05)。(3)老年组动态脉压、24 h收缩压标准差(24 hSSD)、日间收缩压标准差(dSSD)大于青中年组(P<0.05),而两组24 h舒张压标准差(24 hDSD)、日间舒张压标准差(dDSD)、夜间收缩压标准差(nSSD)、夜间舒张压标准差(nDSD)比较差异均无统计学意义(P>0.05)。(4)两组血压节律类型分布比较差异均无统计学意义(P>0.05),但分布规律均为非勺型>勺型>反勺型>深勺型,非勺型血压达50%左右。结论:青中年病人舒张压异常的人数更多、舒张压水平更高;老年病人脉压和血压波动更大。夜间血压水平尤其是舒张压增高及其年轻化需要格外关注。Objective:To analyze the blood pressure characteristics of patients with essential hypertension of different ages,so as to provide guidance for the precise management of hypertension.Methods:The 504 patients with essential hypertension were recruited in the outpatient department of First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from May 2014 to April 2019 and clinical datm were analyzed retrospectively.The patients were divided into young group,middle-aged group(<60 years old),and elderly group(≥60 years old).Ambulatory blood pressure monitoring was performed to analyze the blood pressure in 24 h,daytime,and nighttime mean blood pressure,blood pressure type distribution,pulse pressure,blood pressure variability,and characteristics of blood pressure rhythm.Results:(1)The course of disease in the elderly group was significantly longer(P<0.05),with there were more non-smoking patients(P<0.05),and the higher medication rate(P<0.05).The BMI of young and middle-aged group was higher(P<0.05),with the higher education level(P<0.05).(2)The mean values of ambulatory blood pressure of two groups generally exceeded the diagnostic criteria,especially nighttime blood pressure.The number of patients with elevated diastolic blood pressure and the level of diastolic blood pressure in young and middle-aged group were higher than those in elderly group(P<0.05).There was no significant difference in dynamic systolic blood pressure between two groups(P>0.05).(3)The dynamic pulse pressure,24 h systolic standard deviation(24 hSSD),and daytime systolic standard deviation(dSSD)of elderly group were higher than those of young and middle-aged group(P<0.05),but there were no significant differences in 24 h diastolic standard deviation(24 hDSD),daytime diastolic standard deviation(dDSD),nighttime systolic standard deviation(nSSD),and nighttime diastolic standard deviation(nDSD)between two groups(P>0.05).(4)There were no significant difference in the distribution of blood pressure rhythm types between two gr

关 键 词：高血压 年龄 夜间血压 血压管理 

分 类 号：R544.1[医药卫生—心血管疾病]