老年高血压患者动态血压特点及影响因素分析

目的：本研究主要研究老年高血压患者动态血压特点，并探讨老年高血压患者血压昼夜节律的影响因素。方法：筛选2021年1月到6月山西白求恩医院高血压门诊符合条件的老年高血压患者296位作为研究对象（年龄≥60岁）。根据血压昼夜节律分为杓型组56例（18.9%）、非杓型组134例（45.3%）、反杓型组106例（35.8%）。收集患者一般临床资料，完善24小时动态血压监测、动脉硬化监测、24h尿电解质及24h尿微量白蛋白检测。研究结果通过SPSS26.0软件进行统计学分析，以P＜0.05表示差异有统计学意义。结果：老年高血压患者血压昼夜节律异常（非杓型和反杓型血压）占81.1%，明显高于血压节律正常组；三组间BMI、性别、饮酒史、24hSBP、24hDBP、全天血压负荷值、右ABI、左ABI、24h尿钾、24h尿氯差异无统计学意义（P＞0.05）。年龄、吸烟史、dSBP、dDBP、nSBP、nDBP、夜间血压下降率、右baPWV、左baPWV、24h尿钠、24h尿微量白蛋白差异有统计学意义（P＜0.05）。多因素Logistic回归分析结果显示：年龄（OR=1.302，95%CI：1.162-1.459，P＜0.001）、吸烟史（OR=12.440，95%CI：4.083-37.901，P＜0.001）、24h尿钠（OR=0.987，95%CI：0.978-0.997，P=0.008）是引起老年高血压患者血压昼夜节律异常的独立影响因素。结论：在老年高血压患者中血压昼夜节律异常（非杓型和反杓型节律）发生率明显增高；年龄、吸烟史、24h尿钠是引起老年高血压患者血压昼夜节律异常的独立影响因素。

Analysis of ambulatory blood pressure and its influencing factors in elderly patients with hypertension

Objective:This study mainly studied the characteristics of ambulatory blood pressure in elderly patients with hypertension, and explored the factors affecting the circadian rhythm of blood pressure in elderly patients with hypertension.Methods:A total of 296 eligible elderly hypertension patients (aged ≥60 years) were selected from the hypertension clinic of Shanxi Bethune Hospital from January to June 2021. According to the circadian rhythm of blood pressure, they were divided into 56 patients (18.9%) in the dipper group, 134 patients (45.3%) in the non-dipper group, and 106 patients (35.8%) in the reverse dipper group. General clinical data of patients were collected, and 24-hour ambulatory blood pressure monitoring, arteriosclerosis monitoring, 24h urine electrolyte and 24h urine microalbumin detection were improved.The results were statistically analyzed by SPSS26.0 software, and P < 0.05 was considered statistically significant .Results:Abnormal circadian rhythm of blood pressure (non-dipper group and reverse dipper group) accounted for 81.1% of the elderly hypertension patients, which was significantly higher than that of the normal blood pressure rhythm group；There were no significant difference in the BMI, gender, drinking history, 24hSBP, 24hDBP , whole-day blood pressure load, right ABI, left ABI, 24h urine potassium, 24h urine chloride(P > 0.05)；There were significant difference in the age, smoking historyamong , dSBP, dDBP, nSBP, nDBP, nocturnal blood pressure drop rate, right baPWV, left baPWV , 24h urine sodium and 24h urine microalbumin (P < 0.05)；Multivariate Logistic regression analysis showed that age （OR=1.302，95%CI：1.162-1.459，P＜0.001）, smoking history（OR=12.440，95%CI：4.083-37.901，P＜0.001）and 24h sodium urine（OR=0.987，95%CI：0.978-0.997，P=0.008）were the independent influencing factors for abnormal circadian rhythm of blood pressure in elderly patients with hypertension.Conclusion：The incidence of abnormal circadian rhythm of blood pressure (non-dipper and reverse dipper rhythm) was significantly increased in elderly patients with hypertension；The Age, smoking history and 24h urine sodium were the independent influencing factors for abnormal circadian rhythm of blood pressure in elderly patients with hypertension.