老年高血压患者凌晨血压增高与心率变异性的相关性研究

目的观察老年高血压患者凌晨血压增高与心率变异（HRV）的关系。方法采用动态血压监测仪分析136例原发性老年高血压患者的凌晨血压特点。凌晨血压增高≥54．5mmHg判定为凌晨血压增高（MBPS，n=38），凌晨血压增高〈54．5mmHg判定为非凌晨血压增高（NMBPS，n=98），用动态心电图对其心率变异性的时域和频域参数进行分析。结果（1）与NMBPS相比，MBPS的凌晨收缩压、舒张压、脉压较高（P〈0．01）。（2）MBPS组的SDNN、SDANN、rMSSD、PNN50、LF、HF明显低于NMBPS组（P〈0．01或P〈0．05），MBPS组LF／HF明显高于NMBPS组（P〈0．05）。（3）凌晨血压与SDNN、SDANN、LF、PNN50呈负相关（P〈0．01或P〈0．05）。结论老年高血压患者凌晨血压增高与HRV密切相关。

The relationship between morning blood pressure surge and heart rate variability in elderly patients with hypertension

Objective To investigate the relationship between morning blood pressure surge and heart rate variability in elderly patients with hypertension. Method With ambulatory blood pressure monitor, the characteristics of morning blood pressure in 136 elderly hypertensive patients were analyzed. The morning blood pressure surge （MBPS） was defined as more than 54.5mmHg in morning blood pressure, and the non - morning blood pressure surge （NMBPS） was defined as less than 54.5mmHg. The indexes of time domain and frequency domain were mea sured by the 24h dynamic electrocardiography. Results （ 1 ） The morning systolic blood pressure （ SBP）, diastol＇c blood pressure （DBP）, pulse pressure （PP） in MBPS patients were higher than those in NMBPS （P 〈0. O1 ）. （2） In patients with MBPS, the indexes included SDNN, SDANN, rMSSD, PNNSO, LF and HF was lower than those in patients with NMBPS （P 〈 0.01 or P 〈 0. 05 ）. （3） Furthermore, the morning blood pressure had negative correlation with SDNN, SDANN, LF, PNN50 （P 〈 0.01 or P 〈 0.05）. Conclusion In elderly patients with hypertension, the morning blood pressure surge had closely relationship with heart rate variability.