老年高血压患者血压晨峰与卒中、左心室肥厚及对颈动脉IMT增厚的关系

目的探讨老年原发性高血压病患者血压晨峰(MBPS)与发生卒中、左心室肥厚及颈动脉内膜中层增厚的关系。方法对280例接受抗高血压治疗的老年高血压病患者,以进行24h动态血压监测(ABPM),结果分为:晨峰组患者96例(MBPS≥35 mmHg),非晨峰组患者184例(MBPS35mmHg)。采集患者卒中病史,同时行超声心动图及颈动脉超声检查。检测并记录两组患者血脂、血糖、肾功能等指标,探讨血压晨峰与发生卒中、左心室肥厚、双侧颈动脉内膜中层厚度(IMT)的关系。结果晨峰组患者卒中发生率为40.6%,非晨峰组发生率为28.3%,两组卒中发生率有统计学差异(P0.01)。晨峰组左心室肥厚发生率54.2%,非晨峰组发生率为40.2%,两组左心室肥厚发生率有统计学差异(P0.05);晨峰组颈动脉内膜增厚发生率为65.6%,非晨峰组发生率为52.7%,两组颈动脉IMT增厚发生率有统计学差异(P0.05)。结论老年高血压血压晨峰患者卒中、左心室肥厚、颈动脉IMT增厚发生率增高,降压治疗的同时应积极治疗血压晨峰,减少靶器官损害。

Relationship between morning blood pressure surge and stroke,left ventricular hypertrophy and carotid ;intima-media thickness in elderly patients with essential hypertension

Objective To investigate the relationship between morning blood pressure surge （MBPS） and stroke, left ventricular hypertrophy （LVH） and carotid intima-media thickness （CA-IMT） in elderly patients with essential hypertension. Methods The aged hypertensive patients （n=280） treated with anti-hypertension therapy were given 24-h ambulatory blood pressure monitoring （ABPM） and divided into MBPS group （n=96, MBPS≥35 mmHg） and non-MBPS group （n=184, MBPS〈35 mmHg）. The data of stroke history was collected from the patients, and all patients were given echocardiogram and carotid artery ultrasound examinations. The indexes of blood fat, plasma glucose and renal function were detected and recorded in 2 groups. The relationship between MBPS and stroke, LVH and CA-IMT was investigated. Results The incidence rate of stroke was 40.6%in MBPS group and 28.3%in non-MBPS group （P〈0.01）. The incidence rate of LVH was 54.2%in MBPS group and 40.2%in non-MBPS group （P〈0.05）. The incidence rate of CA-IMT incrassation was 65.6%in MBPS group and 52.7%in non-MBPS group （P〈0.05）. Conclusion The incidence rates of stroke, LVH and CA-IMT incrassation will increase in elderly patients with MBPS of essential hypertension, so at the same time of anti-hypertension, MBPS should be controlled for relieving target organ damage.