高血压与中老年女性骨密度的关系  

The relationship of hypertension to bone mineral density in mid-elderly women

作　　者：徐君翔[1] 刘晨[2] 张鹏[2] 徐又佳[2] 

机构地区：[1]宁波市医疗中心李惠利医院,浙江宁波315000 [2]苏州大学附属第二医院

出　　处：《中国老年学杂志》2015年第4期872-876,共5页Chinese Journal of Gerontology

基　　金：国家自然科学基金资助项目(No.81273090);苏州市科技基础设施建设计划之高技术研究重点实验室资助项(No.SZS201208);江苏省科技支撑计划(社会发展)项目(No.BE2011605)

摘　　要：目的探讨中老年女性高血压患者与非高血压人群骨密度(BMD)的差异及常用降高血压药物的使用情况与BMD的关系。方法采用横断面研究方法,1 961例符合要求的女性(40~89岁)纳入研究,采用问卷调查收集一般情况、慢性病用药史、生活习惯等信息,测量血压、身高、体重,运用超声骨密度仪(型号:SAHARA)检测足跟部位BMD,对相关数据进行统计学分析。结果高血压组中使用降压药物的BMD均值为(0.416±0.098)g/cm2,没有使用降压药物的BMD均值为(0.401±0.121)g/cm2,均显著低于非高血压组(P<0.05);控制混杂因素后,仍存在显著性差异(P<0.05)。高血压患者中,使用降压药物的BMD均值高于没有用药组;控制变量后,两者比较存在统计学差异(P<0.01)。单种降压药物使用的BMD均值显著高于两种或3种药物联合使用的情况(P<0.05);单种使用四类降压药物BMD均值的高低顺序为:血管紧张素转化酶抑制剂/血管紧张素受体抑制剂(ACEI/ARB)类>噻嗪类利尿剂>钙通道拮抗剂>β受体抑制剂。调整变量后,使用ACEI/ARB类或噻嗪类利尿剂者的BMD均值显著高于没有用药的高血压患者,与非高血压组比较没有显著差异(P<0.05),使用钙通道拮抗剂者BMD均值高于没有用药的高血压患者,低于非高血压组(P<0.01)。使用β受体抑制剂者BMD均值显著低于使用其他三类药物的患者(P<0.05)。结论中老年女性高血压与BMD降低有关;不同降高血压药物的使用者BMD存在差异。Objective To determine the relationship of hypertension and bone mineral density in mid-elderly women. Methods The questionnaire was used to collect the general information,drugs use,living habits of 1 961 qualified women. All participants underwent blood pressure,height and weight measurement. Bone mineral density was detected by calcaneus absorptiometry. Results 1The average BMD in hypertension group with antihypertensive was( 0. 416±0. 098) g / cm2,and without antihypertensive was( 0. 401±0. 121) g/cm2,either of which was lower than that of non-hypertensive group. After adjustment for cofounders,the difference remained significant. 2Among the hypertensive women,the average BMD was higher in group with antihypertensive,the difference was significant after adjustment for other factors. The group with single drug had higher average BMD than those with joint use of drugs. 3Comparing the average BMD among four groups with each kind of single-used antihypertensive medication,the order was: ACEI / ARB> Thiazide diuretics> calcium channel blockers>β receptor inhibitors. After adjustment for other factors,the average BMD in the group with use of ACEI /ARB or Thiazide diuretics was significant higher than that of hypertensive group without antihypertensive,and had no difference with the non-hypertensive group. The average BMD in the group with use of calcium channel blockers was higher than that of hypertensive group without antihypertensive,and lower than that of non-hypertensive group. The average BMD in the group with β receptor inhibitors was significant lower than that of the groups with other three kinds of antihypertensive. Conclusions Hypertension is associated with reduced BMD in mid-elderly women. Divergence of BMD exists among women with different antihypertensive drugs.

关 键 词：骨密度 高血压 降压药 

分 类 号：R544.1[医药卫生—心血管疾病]