高龄高血压病患者昼夜血压节律对左心室肥厚和左心室功能的影响

目的　观察高龄高血压病患者昼夜血压节律对左心室肥厚和左心室功能的影响。方法　根据夜间血压下降率将 6 8例年龄≥ 80岁的高血压病患者分为非杓型组和杓型组 ,应用 2 4h动态血压监测和超声心动图观察并比较高血压病患者的动态血压节律以及左心室结构和功能的特点。结果　非杓型组 2 4h收缩压、2 4h舒张压、夜间收缩压、夜间舒张压明显高于杓型组。非杓型组较杓型组左心室重量及左心室重量指数明显增加 ,舒张早期血流 (E波 )的峰值流速减慢 ;心房收缩期血流的峰值流速增大 ;心房收缩期血流的峰值流速 舒张早期血流的峰值流速比值加大。结论　非杓型血压节律的高龄高血压病患者较杓型血压节律者的左心室肥厚和左心室舒张功能减退发生率更高

Influence of circadian blood pressure rhythm on left ventricular structure and function in very old hypertensives

Objective To investigate the influence of circadian blood pressure rhythm on left ventricular structure and function in very old patients with hypertension. Methods Sixty-eight very old patients with hypertension (≥80 years old) were divided into two groups according to their blood pressure decreasing rate at night(<10% into non-dipper group,≥10% into dipper group).The circadian blood pressure rhythm, left ventricular structure and function of these patients were measured respectively with ambulatory blood pressure monitor and echocardiography.Results 24 h SBP,24 h DBP, night SBP and night DBP were significantly higher in non-dipper group than those in dipper group.Left ventricular mass and left ventricular mass index were significantly increased,peak flow velocity of early diastole was decreased, peak flow velocity of auricular contraction and the ratio of A/E were increased in non-dipper group compared with those in dipper group.Conclusion The incidences of left ventricular hypertrophy and left ventricular diastole function impairment were higher in non-dipper patients than in dipper patients.