老年代谢综合征患者高血压临床特点分析

目的分析老年代谢综合征(MS)患者高血压的临床特点。方法回顾性分析2005年行年度体检的老年干部资料,按年龄分为≤70岁、71~80岁、>80岁3组,分析各组MS单一组分及多组分聚集后的临床特点;以有无高血压伴其他代谢异常分为5组,比较各年龄组高血压作为MS单一组分及与其他组分聚集后的临床特点;分析心、脑血管病变及肾功能异常在上述各组中的患病特点。结果本研究人群中,伴存1种以上MS组分异常的超过85%。MS的患病率为32.19%,其中4项代谢指标均异常的占8.16%。MS中最多见的组合是血压、血糖及体重指数(BMI)3项代谢异常,患病率为24.67%。高血压是最常见的代谢异常,占总人数的61.78%,按年龄分组比较后可见其患病率存在明显的增龄趋势。高血压患者中有46.67%可诊断为MS,占MS总人数的89.57%,而非高血压MS者仅占MS总人数的10.43%。单纯高血压只占高血压患者的22.87%。高血压MS组罹患心血管并发症的比例最高(73.52%),其次是高血压伴其他1项代谢异常(72.69%);脑血管病患病率各组间未见显著性差异。高血压MS患者肾功能异常的检出率也明显增加,分别为非高血压非MS、非高血压MS患者的1.69和1.65倍。结论老年人MS的患病率高。高血压在MS中是最常见的异常组分,其患者中约2/3合并有其他代谢异常。MS伴高血压患者心血管病患病率高,肾功能异常的检出率也高。

Clinical characteristics of hypertension in the aged patients with metabolic syndrome

Objective To analyze the characteristics of hypertension by cross-sectional study of the aged patients with metabolic syndrome (MS). Methods The data, collected from senile population who underwent medical examination in the General Hospital of PLA in 2005, were analyzed retrospectively in order to identify the clinical features of hypertension in aged patients with MS, and the significance of hypertension, as single or one of the components of MS, the prevalence of MS, including the prevalence of MS and its component ailments, prevalence of hypertension in MS population, the constituent ratio of MS and coronary heart disease, and cerebrovascular disease in patients with hypertension. Results The prevalence of MS was 32.19%, in which 8.16% patients were having all the four metabolic abnormalities. Hypertension was the most common metabolic abnormality with a prevalence of 61.78%, which tended to increase with increasing age. The most common combination in MS was abnormalities of blood pressure, glucose and BMI, with a prevalence of 24.67%. Among the population with hypertension, 46.67% of them could be diagnosed as MS, accounting for 89.57% of all MS patients. Patients with MS but without hypertension accounted for only 10.43%. Hypertension complicated with MS or another metabolic disorder showed a high risk of cardiovascular diseases, and the prevalence was 73.52% and 72.69%, respectively. No significant difference was found in the incidence of cerebrovascular disease. The prevalence of abnormal renal function was significantly increased in the group of MS with hypertension, by 1.69 and 1.65 folds of that in the group without MS and the group only with MS and without hypertension. Conclusions There was higher prevalence of MS in the elderly people, and in about 2/3 hypertensive patients it co-existed with one of the components of MS. Hypertension was the most common disorder in MS. Patients with MS and hypertension are having a higher risk of suffering from cardiovascular diseases and abnormal renal function.