老年高血压病患者动态血压与颈动脉粥样硬化的关系

目的:研究老年原发性高血压(EH)患者24h动态血压(ABPM)与颈动脉粥样硬化(CAS)的关系。方法:采用袖带式动态血压仪监测100例老年EH患者的ABPM,彩色超声测量颈动脉内-中膜厚度,有CAS者为研究组,无CAS者为对照组,研究ABPM参数与CAS之间的关系。结果:老年EH患者血压控制达标后,血压曲线异常呈非杓型者明显增多,占66.0%;两组24h平均收缩压和舒张压之间无明显差异,但研究组的动态脉压,日间脉压和夜间脉压[分别是(53.5 6.8,53.7 7.5和53.6 8.3)mmHg]均较对照组[分别是(48.9 8.1,48.1 10.8和48.5 9.8)mmHg]增大,有显著性差异(P=0.005)。CAS的总发生率是64.0%,而杓型组中CAS的发生率是53.0%,非杓型组是68.0%,两组间无显著性差异(P>0.05)。结论:老年EH患者血压控制达标后,脉压(PP)增大与CAS的发生密切相关;血压昼夜节律异常呈非杓型者明显增多。

Relationship between ambulatory blood pressure and carotid atherosclerosis of senile hypertension

Objective:To study the characteristics of 24 hours ambulatory blood pressure monitoring (ABPM) of senile hypertension (EH) and their correlation with the carotid atherosclerosis (CAS).Methods:All subjects were underwent 24 hours ambulatory blood pressure monitoring and carotid artery intima-medium thickness (n=100),the EH with CAS were investigation group, and the EH without CAS were control group. To compared with the correlation of the parameter of ABPM and the CAS in two groups.Results:The rat of non-dipper among the senile hypertension was significantly raised to 66.0%.The 24 hours mean,day and night pulse pressure [there were (53.5 6.8, 53.7 7.5 and 53.6 8.3) mmHg] with the CAS were increased more significantly than that without the CAS[there were(48.9 8.1,48.1 10.8 and 48.5 9.8)mmHg] (P=0.005).The total rat of carotid atherosclerosis was 64.0 %. It was 53.0 % in the dipper group and that was 68.0 % in the non-dipper group,it showed no significant change between the two groups.Conclusion:The increased pulse pressure(PP) were positively associated with the carotid atherosclerosis,and the patients with non-dipper of blood pressure between daytime and night were increased obviously in senile hypertension.