老年与青年高血压病患者脉压和血压变异性比较

目的 比较老年和青年高血压病患者动态血压的差异,为老年高血压病患者的治疗提供依据.方法 我院高血压科就诊的83例2周内未服药的高血压病患者,60岁≤年龄＜80岁患者40例作为老年组,18岁≤年龄≤30岁患者43例作为青年组.2组患者均进行24 h动态血压监测,并比较结果.结果 老年高血压组的动态脉压、动态脉压指数和24h收缩压变异系数明显高于青年高血压组[(61±12) mm Hg(1 mm Hg=0.133 kPa)比(52 ±9)mm Hg,(0.44±0.07)比(0.37±0.06),(11±2)％比(8±2)％,均P＜0.01];24 h平均舒张压和24h平均心率明显低于青年高血压组[(79±10) mm Hg比(88±12)mm Hg,(69±8)次/mint比(74±9)次/min,均P＜0.01].结论 老年高血压病患者主要以动态脉压增大和24h收缩压变异性升高为特点;而青年患者以24h平均舒张压升高为主.因此,临床对老年高血压病患者进行降压治疗时,选择的药物不仅要有效降低平均收缩压水平,还要改善脉压和血压变异性.

Comparison of pulse pressure and blood pressure variability between elderly hypertention and young hyper-tenion

Objective To compare the differences of pulse pressure and blood pressure variability between elderly hypertension and young hypertention to improve the management of elderly hypertension. Methods Eighty- three hypertension untreated in last two weeks and visiting the Hypertensive Department of Beijing Anzhen Hospital were enrolled and divided into two groups by age： the elderly group （40 cases with age ≥60 years old） and the young group （43 cases with age ≤30 years old）. All underwent 24-hour ambulatory blood pressure monitoring （ABPM）. Results Compared with those of the young group, the pulse pressure, pulse pressure index and 24h systolic blood pressure variability index of the elderly group were significantly increased[ （61±12） mm Hg vs （52±9） mm Hg, 0.44±0.07 vs 0.37±0.06, （ 11±2） % vs （ 8±2） %, P 〈 0.01, respectively ], while 24h mean di- astolic blood pressure and 24h mean heart rate were dramatically decreased [ （79±10）mm Hg vs （88 ±12）mm Hg, （69±8）bpm vs （74±9）bpm, P 〈0.01, respectively . Conclusions Elevated pulse pressure and 24h systolic blood pressure variability index are typical in elderly hypertension patients. Therefore, in the management of elderly hypertension, it is recommended to choose those medicines which not only decrease the mean systolic blood pres- sure, but also improve the performances of pulse pressure and blood pressure variability.