老年原发性高血压患者动态血压指标与靶器官损害的关系

目的:探讨老年原发性高血压(EH)患者动态血压各指标与靶器官损害的关系。方法:选择200例老年EH患者进行24h动态血压监测,其中45例无靶器官损害为EH对照组,155例并发心、脑、肾及多器官损害分别为心损害组(48例)、脑损害组(35例)、肾损害组(38例)、多器官损害组(34例),分析各组24h、白昼、夜间血压负荷值、血压昼夜节律、血压变异性。结果:与EH对照组比较,心损害、脑损害、肾损害、多器官损害组的24h、白昼、夜间血压负荷值明显升高[24h(64±13/53±12)%比(73±13/73±14)%比(77±12/74±11)%比(79±13/78±13)%比(85±12/86±13)%,P<0.01],夜间血压下降率明显降低[(10.6±0.6/10.7±0.6)%比(5.5±0.5/7.8±0.6)%比(5.4±0.5/7.6±0.5)%比(4.3±0.5/6.9±0.4)%比(1.8±0.5/3.0±0.5)%%,P<0.01或P<0.001],血压变异性明显增大[24h血压变异性(9.2±2.1)mmHg比(12.2±2.3)mmHg比(12.5±2.4)mmHg比(12.9±2.1)mmHg比(13.2±2.9)mmHg,P<0.05或P<0.01)];多器官损害组24h、白昼、夜间血压负荷值较心、脑、肾损害组明显升高(P<0.05),夜间血压下降率明显降低(P<0.05或P<0.01),血压变异性明显增大(P<0.05或P<0.01)。结论:老年原发性高血压伴靶器官损害者的血压负荷值明显升高,夜间血压下降率明显降低,血压变异性明显增大。

Relation among indexes of ambulatory blood pressure and target organ damage in aged patients with essential hypertension

Objective： To investigate relation among indexes of ambulatory blood pressure and target organ damage in aged patients with essential hypertension （EH）. Methods： A total of 200 aged EH patients underwent 24h ambulato- ry blood pressure monitoring （ABPM）. A total of 45 patients without target organ damage were regard as EH con- trol group, and 155 patients complicated heart, brain, kidney and multiple organ damage were regard as heart dam- age group （n = 48）, brain damage group （n = 35）, kidney damage group （n = 38） and multiple organ damage group （n = 34） respectively. The 24h, daytime and nighttime blood pressure loads, circadian rhythm of blood pressure and blood pressure variability （BPV） were analyzed in above groups. Results： Compared with EH control group, there were significant increase in 24h, daytime, nighttime blood pressure loads[24 h （64±13/53± 12） % vs. （73 ±13/73 ±14）% vs. （77±12/74±11）% vs. （79±13/78±13）% vs. （85±12 / 86±13）%, P〈0.01], and BPV E24h BPV （9.2±2.1） mmHgvs. （12.2±2.3） mmHgvs. （12.5±2.4） mmHgvs. （12.9±2.1） mmHgvs. （13.2± 2.9） mmHg, P〈0.01 or P（0. 001） , and significant decrease in decrease rate of nighttime blood pressure E （10.6 ±0.6/10.7±0.6）% vs. （5.5±0.5/7.8±0.6）% vs. （5.4±0.5/7.6±0.5）% vs. （4.3±0.5/6.9±0.4）% vs. （1.8 ± 0.5/3.0 ± 0.5）%, P〈0.05 or P〈0.01] in heart, brain, kidney and multiple organ damage group; compared with heart, brain, kidney damage group, there were significant increase in 24h, daytime and nighttime blood pressure loads （P〈0.05） and BPV （ P〈0.05 or P〈0.01）, and significant decrease in decrease rate of nighttime blood pressure （P〈0.05 or P〈0.01） in multiple organ damage group. Conclusion： There are significant increase in blood pressure loads and variability, and significant decrease in decrease rate of nighttime blood pressure in aged patients with essential hypertension complicated target organ damage.