老年高血压病患者血压晨峰与心脏结构及心律失常的相关性

目的探讨老年高血压病患者血压晨峰与心脏结构、心功能及心律失常的相关性。方法选择2006年2月～2007年12月本院门诊或住院的老年高血压病患者,根据动态血压结果分为晨峰组及非晨峰组,对两组动态血压、动态心电图及心脏超声心动图检查检查结果进行比较分析。结果晨峰组室壁增厚、局部运动异常、舒张功能异常(E/A<1)等心脏超声改变较对照组明显增高(p<0.05或者<0.001);晨峰组房性早搏、室性早搏、传导阻滞以及ST-T改变的发生率均较对照组明显增高(p<0.05或者<0.001)。结论老年高血压病患者血压晨峰加剧不仅与心脏结构、心功能及心律失常有明显的相关性,并且独立于年龄、24小时血压平均水平。血压晨峰加剧可能是老年高血压病患者发生心脑血管事件的重要危险因素之一。

STUDY OF CORRELATION BETWEEN CARDIAC STRUCTURE, ARRHYTHMIAS AND MORNING SURGE OF BLOOD PRESSURE IN ELDERLY HYPERTENSION PATIENTS

Objective To investigate the correlation between cardiac structure,arrhythmias and morning surge of blood pressure in elderly hypertension patients.Methods From elderly hypertension patients from our hospital out-patient or in-patient departments were chose and divided into two groups of Morning blood pressure surge and Non-Morning blood pressure surge,according to the results checked,and we conducted a comparative analysis with the results of dynamic blood pressure,dynamic eletrocardiogram and echocardiography in the two groups.Results Such ultrasonic changes in heart as ventricular wall thickening,regional motion abnormalities and diastolic function abnormalities were obviously higher in morning blood pressure surge group than in the control group(p<0.05 or <0.001);and premature atrial contractions,premature ventricular contraction,conduction blockage and ST-T changes have an obviously higher occurrence rate in Morning blood pressure surge group than in the control group(p<0.05 or <0.001).Conclusion Morning blood pressure surge aggravating not only has obvious correlation with cardiac structure,cardiac function and arrhythmias but also is independent from age and blood pressure average level in 24 hours.The aggravating of morning blood pressure is possible one of important risk factor in the cerebrovascular events of elderly hypertension patients.