老老年高血压患者动脉僵硬度与靶器官损害的相关性

目的探讨老老年高血压患者动脉僵硬度与靶器官损害的相关性。方法将349例受试者依据年龄和血压分为3组:将60～79岁高血压患者作为老年高血压组(Ⅰ组,122例),年龄≥80岁高血压患者作为老老年高血压组(Ⅱ组,105例),年龄≥80岁血压正常者作为老老年正常血压组(Ⅲ组,1 22例)。动脉脉搏波速度测定仪测定臂踝脉搏波速度(baPWV);彩色超声心动图检测左心室结构,计算左心室重量指数(LVMI);检测24 h尿微量白蛋白及肌酐,计算尿微量蛋白肌酐的比率(ACR),并进行相关分析。结果Ⅱ组患者baPWV和LVMI明显高于Ⅲ组和Ⅰ组,差异有统计学意义(P<0.01)。与Ⅲ组比较,Ⅰ组、Ⅱ组尿微量白蛋白和ACR明显增加,差异有统计学意义(P<0.05)。baPWV与LVMI、ACR、收缩压、舒张压、脉压、体重指数和年龄呈正相关(r=0.40、0.24、0.37、0.20、0.20、0.22、0.52,P<0.05,P<0.01)。年龄、收缩压和体重指数对baPWV有独立的影响作用;baPWV是影响LVMI和ACR的主要因素。结论老老年原发性高血压患者动脉僵硬度增加,且与靶器官损害密切相关。

Relationship between arterial stiffness and target-organ damage in very old hypertensives

objective To investigate the changes of arterial stiffness,and the relationship between arterial stiffness and target-organ damage in very old hypertensives.Methods 349 subjects were divided into three groups according to blood pressure level and age:old hypertension group(n= 122),very old hypertension group(n=105) and very old normotension group(n=122).All subjects underwent echocardiographic measurement of left ventricular structure,laboratory meas urement of urinary creatinine and urinary albumin and measurement of brachial-ankle pulse wave velocity(baPWV) by using an automatic waveform analyzer.Results baPWV was significantly faster in very old hypertension group than in other two groups(P<0.01).LVMI was significantly higher in very old hypertension group than in old hypertension group and normotension group(P<0.01).Urinary albumin and ratio of urinary albumin to urinary creatinine(ACR) of very old hypertension group and old hypertension group were significantly increased compared with very old normotension group(P<0.05).baPWV correlated positively with LVMI,ACR, SBP,DBP,PP,BMI and age(r=0.40,0.24,0.37,0.20,0.20,0.22,0.52,P<0.05,P<0.01). Multiple regression analysis showed that age,SBP,BMI were main factors that influenced baPWV.baPWV was the main determinant for LVMI and ACR.Conclusions Arterial stiffness increased in very old hypertensives,which was closely related to target-organ damage.