不同膳食结构对老年高血压病人早餐后低血压的影响  

Effects of different dietary structures on postprandial hypotension after breakfast in elderly patients with hypertension

作　　者：邬王怡 赵春艳[2] 孙玉肖[3] WU Wangyi;ZHAO Chunyan;SUN Yuxiao(School of Medicine,Tongji University,Shanghai 200092,China;Department of Nursing,East Hospital Affiliated to Tongji University,Shanghai 200120,China;Department of Cardiovascular Medicine,East Hospital Affiliated to Tongji University,Shanghai 200120,China)

机构地区：[1]同济大学医学院,上海市200092 [2]同济大学附属东方医院护理部,上海市200120 [3]同济大学附属东方医院心血管内科,上海市200120

出　　处：《实用老年医学》2025年第1期88-92,97,共6页Practical Geriatrics

摘　　要：目的探讨老年高血压病人进食不同膳食结构早餐对餐后血压、心率、餐后低血压(postprandial hypotension,PPH)发生率及临床症状的影响。方法采用便利抽样法,选取2021年6月至2022年10月同济大学附属东方医院心内科收治的185例老年原发性高血压病人为研究对象。按照入院时间分组,最终纳入高碳水组61例、高蛋白组62例、对照组62例。高碳水组接受碳水化合物供能比为85%的早餐,高蛋白组接受蛋白质供能比为28%的早餐,对照组接受碳水化合物供能比为57%、蛋白质供能比为14%的早餐。记录并比较3组病人餐前和餐后30、60、90、120 min的血压、心率,PPH发生率和PPH相关症状的发生情况。结果高碳水组病人餐后血压在餐后30~120 min呈连续下降趋势,餐后60~120 min SBP水平显著低于高蛋白组和对照组。高碳水组PPH发生率为67.2%,显著高于高蛋白组(32.3%)和对照组(41.9%),差异有统计学意义(P<0.01)。结论减少碳水化合物含量、增加蛋白质含量的膳食能减少老年高血压病人早餐后血压下降幅度,降低PPH发生率。Objective To investigate the effects of different dietary structures on postprandial blood pressure,heart rate,incidences of postprandial hypotension(PPH)and clinical symptoms in the elderly patients with hypertension.Methods A total of 185 elderly patients with primary hypertension admitted to Department of Cardiology,East Hospital Affiliated to Tongji University from June 2021 to October 2022 were enrolled in this study by convenience sampling method.According to the time of admission,61 cases were enrolled in the high-carbohydrate group,62 cases enrolled in the high-protein group and 62 cases enrolled in the control group.The high-carbohydrate group received a breakfast with 85%of energy from carbohydrates,the high-protein group received a breakfast with 28%of energy from protein,and the control group received a breakfast with 57%of energy from carbohydrates and 14%of energy from protein.Blood pressure and heart rate were measured before breakfast and 30,60,90,120 minutes after breakfast,and the incidences of PPH and clinical symptoms were recorded and compared among the three groups.Results The postprandial blood pressure in the high-carbohydrate group showed a continuous downward trend from 30 to 120 min after breakfast.The level of systolic blood pressure(SBP)from 60 to 120 min after breakfast in the high-carbohydrate group was significantly lower than that in high-protein group and the control group(P<0.05 or P<0.01).The incidence rate of PPH in the high-carbohydrate group(67.2%)was significantly higher than that in the high-protein group(32.3%)and the control group(41.9%)(P<0.01).Conclusions Reducing carbohydrate content and increasing protein content can reduce the drop of blood pressure after breakfast in the elderly patients with primary hypertension,and can reduce the incidence of PPH.

关 键 词：膳食结构 高血压 老年人 餐后低血压 

分 类 号：R473.5[医药卫生—护理学]