老年高血压患者血压节律变化与靶器官损害的关系

目的 探讨老年高血压患者血压节律变化与靶器官损害的关系. 方法 70例老年高血压患者均行24h动态血压检测、颈动脉超声和超声心动图检查,根据24 h动态血压检测结果分为2组:勺形组40例及非勺形组30例,并对2组颈动脉粥样硬化(CAS)、左室肥厚(LVH)及动态血压各参数进行比较. 结果 CAS及LVH检出率非勺形组均高于勺形组(P＜0.01)；2组间24 h平均收缩压(24hSBP)及舒张压(24hDBP)、24 h收缩压和舒张压负荷值(24hSBPL、24hDBPL),差异无统计学意义(P＞0.05).勺形组白天平均收缩压(dSBP)及舒张压(dDBP)、白天收缩压和舒张压负荷值(dSBPL、dDBPL)高于非勺形组(P＜0.05).勺形组夜间平均收缩压(nSBP)及舒张压(nDBP)、夜间收缩压和舒张压负荷值(nSBPL、nDBPL)明显低于非勺形组(P＜0.01). 结论 老年高血压患者血压节律变化的消失与靶器官损害关系密切,高血压患者降压治疗的同时还需纠正紊乱的血压昼夜节律.

Relationship between the changing rhythm of blood pressure and the damage of target organ in elderly patients with hypertension

Objective To investigate the relationship between the rhythm of blood pressure changes and the damage of the target organ in elderly hypertensive patients.Methods Seventy cases of elderly patients with hypertension underwent 24-hour ambulatory blood pressure monitoring carotid artery ultrasound and echocardiography examination.According to 24 hour dynamic blood pressure examination result,the patients were divided into 2 groups:Spoon-shaped group(40 cases) and non-spoon-shaped group(30 cases).Carotid atherosclerosis(CAS),left ventricular hypertrophy(LVH) and dynamic parameters of ambulatory blood pressure monitoring were analyzed.Results The detection rate of CAS and LVH in non-spoon-group were higher than those in spoon-shaped group(P<0.01);There were no statistical differences in 24-hour average systolic blood pressure(24hSBP) and diastolic blood pressure(24hDBP),24 hour systolic pressure load value(24hSBPL) and diastolic blood pressure load value(24hDBPL) between the 2 groups(P>0.05).Daytime systolic blood pressure(dSBP) and diastolic blood pressure(dDBP),daytime systolic pressure load value(dSBPL) and diastolic blood pressure load value(dDBPL) in spoon-shaped group was higher than that in non-spoon-shaped group(P<0.05).Night systolic blood pressure(nSBP) and diastolic blood pressure(nDBP),night systolic pressure load value(nSBPL) and diastolic blood pressure load value(nDBPL) in spoon-shaped group was lower than that in the non-spoon-shaped group(P<0.01).Conclusions Relationship in the disappearance of rhythm changes of blood pressure and target organ damage is closer in elderly hypertensive patients.At the same time of antihypertensive therapy,the disorder of circadian rhythm of blood pressure in elderly hypertensive patients should be also corrected.