老年H型高血压患者364例动态血压变异性及动脉硬化特点

发布时间：2018-05-16 18:49

本文选题：老年 + 高血压　；参考：《广东医学》2017年07期

【摘要】：目的观察老年H型高血压患者的动态血压变异性、血压昼夜节律及动脉硬化特点。方法选择广州军区广州总医院体检离退休老年男性原发性高血压患者364例,分别进行血浆同型半胱氨酸(Hcy)水平测定和动态血压、心-踝血管指数(CAVI)测定,根据Hcy水平分为H型高血压组和非H型高血压组。分析比较两组间的血压变异性、动脉硬化特点。结果与非H型高血压组相比,H型高血压患者动态血压表现为非杓型和反杓型明显增多。H型高血压组患者24h平均收缩压标准差、日间收缩压标准差、日间舒张压标准差、夜间收缩压标准差、24h收缩压加权标准差、24h舒张压加权标准差明显增高,差异有统计学意义(均P0.05)。H型高血压组患者两侧CAVI与非H型高血压组相比均明显升高,差异有统计学意义(均P0.05)。多元线性回归分析显示年龄、收缩压、Hb A1C、体质指数及Hcy是CAVI的独立影响因素(β=0.231、0.132、0.123、-0.157、0.096,均P0.05)。结论老年H型高血压患者血压变异性增高及昼夜节律减弱,动脉僵硬度增大,年龄、收缩压、Hb A1C、体质指数及Hcy等心脑血管病危险因素对CAVI具有显著影响。
[Abstract]:Objective to observe the characteristics of ambulatory blood pressure variability, circadian rhythm of blood pressure and arteriosclerosis in elderly patients with H type hypertension. Methods 364 retired male patients with essential hypertension were selected from Guangzhou General Hospital of Guangzhou military region. Plasma homocysteine (Hcy) level, ambulatory blood pressure (ABBP) and cardio-malleolar vascular index (CAVI) were measured respectively. According to the level of Hcy, the patients were divided into H type hypertension group and non H type hypertension group. Blood pressure variability and arteriosclerosis were analyzed and compared between the two groups. Results compared with the non-H type hypertension group, the ambulatory blood pressure of the patients with H type hypertension was obviously increased in the non dipper type and anti dipper type. The mean systolic blood pressure standard deviation and the daytime diastolic blood pressure standard deviation in the H type hypertension group were significantly higher than those in the non H type hypertension group. Nocturnal systolic blood pressure standard deviation and 24h systolic blood pressure weighted standard deviation were significantly higher than those of non-H type hypertension group (P 0.05), and the difference was statistically significant (P 0.05 路H type hypertension group and non-H type hypertension group), the bilateral CAVI was significantly higher than that in non-H type hypertension group. The difference was statistically significant (P 0.05). Multiple linear regression analysis showed that age, systolic blood pressure (SBP) HbA1C, BMI and Hcy were independent influencing factors of CAVI (尾 -0.231U 0.132U 0.123- 0.157U 0.096, all P 0.05). Conclusion in elderly patients with H type hypertension, increased blood pressure variability and decreased circadian rhythm, increased arterial stiffness, age, systolic blood pressure HbA1C, body mass index, Hcy and other cardiovascular and cerebrovascular disease risk factors have significant effects on CAVI.
【作者单位】：广州中医药大学;广州军区广州总医院老年心血管内科;
【基金】：广州市科技计划项目(编号:2013Y2-00130,201508020253)
【分类号】：R544.1;R543.5

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