血压变异性对老年冠心病合并高血压患者远期预后的预测价值  

Predictive value of blood pressure variability for long-term prognosis in elderly hypertension patients with coronary heart disease

作　　者：刘海明[1] 张娜[1] 张俊仕[1] Liu Haiming;Zhang Na;Zhang Junshi(Department of Hypertension,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆医科大学第一附属医院高血压科,乌鲁木齐830054

出　　处：《中华老年心脑血管病杂志》2024年第9期1016-1019,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：新疆维吾尔自治区自然科学基金(2022D01C238)。

摘　　要：目的 探讨血压变异性对老年冠心病合并高血压患者远期预后的预测价值。方法 回顾性收集2015年1月至2018年1月新疆医科大学第一附属医院收治的老年冠心病合并高血压患者272例,随访5年,根据患者有无发生不良心血管事件,将患者分为不良心血管事件组(102例)和对照组(170例)。比较2组患者临床特征差异,用ROC曲线分析首次入院时血压变异性对老年冠心病合并高血压患者发生不良心血管事件的预测价值,用多因素logistics回归分析探讨老年冠心病合并高血压患者发生不良心血管事件的危险因素。结果 与对照组比较,不良心血管事件组患者糖尿病发生率、冠状动脉狭窄程度>75%比例、24 h收缩压变异性显著增高(P<0.05,P<0.01)。24 h收缩压变异性预测老年冠心病合并高血压患者发生不良心血管事件的曲线下面积为0.777(95%CI:0.720~0.835,P=0.000)。24 h收缩压变异性≥11.71 mm Hg(1 mm Hg=0.133 kPa,OR=5.017,95%CI:2.911~8.647,P=0.000)、糖尿病(OR=2.479,95%CI:1.231~4.993,P=0.011)、冠状动脉狭窄程度>75%(OR=2.303,95%CI:1.022~5.190,P=0.044)是老年冠心病合并高血压患者发生不良心血管事件的独立危险因素。结论 24 h收缩压变异性可以用于预测老年冠心病合并高血压患者不良心血管事件的发生。Objective To explore the predictive value of blood pressure variability for long-term prognosis in elderly hypertension patients with coronary heart disease(CHD).Methods A total of 272 elderly patients with CHD and hypertension admitted to our hospital from January 2015 to January 2018 were enrolled retrospectively, and all of them were followed up for 5 years.According to that they had adverse cardiovascular events or not, they were divided into adverse cardiovascular events group(n=102) and control group(n=170).The differences in clinical features were compared between the two groups.ROC curve was plotted to analyze the value of blood pressure variability at first admission in predicting adverse cardiovascular events in elderly hypertension patients with CHD.Multivariate logistic regression analysis was applied to identify the risk factors for adverse cardiovascular events in these patients.Results Compared with the control group, the incidence of diabetes, the proportion of coronary artery stenosis >75%,and 24-hour SBP variability were significantly higher in the adverse cardiovascular events group(P<0.05,P<0.01).The area under curve value of 24-hour SBP variability in predicting adverse cardiovascular events in elderly patients with CHD and hypertension was 0.777(95%CI:0.720-0.835,P=0.000).24-hour SBP variability ≥11.71 mm Hg(1 mm Hg=0.133 kPa, OR=5.017,95%CI:2.911-8.647,P=0.000),diabetes(OR=2.479,95%CI:1.231-4.993,P=0.011),and coronary artery stenosis >75%(OR=2.303,95%CI:1.022-5.190,P=0.044) were independent risk factors for adverse cardiovascular events in elderly patients with CHD and hypertension.Conclusion 24-hour SBP variability can be used to predict the occurrence of adverse cardiovascular events in elderly hypertension patients with CHD.

关 键 词：冠心病 高血压 预后 预测 血压变异性 

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