血压负荷与老年高血压病并靶器官损害

目的 :采用动态血压 (ABPM)监测方法研究老年原发性高血压 (EH)患者的血压负荷变化与靶器官受损的关系。方法 :对 86例老年 (EH)患者进行 2 4h动态血压监测 ,根据检测结果随机分为杓型组或非杓型组 ,并分析血压负荷与高血压所致的靶器官损害 (心房纤颤、室性心律失常 ,充血性心力衰竭、脑血管意外 )进行比较。结果 :2 4h动态平均收缩压 (SBP)和平均舒张压(DBP)与上述各项事件有明显差异 (P <0 .0 1) ,脑血管意外发生与夜间平均SBP、DBP有显著差异 (P <0 .0 1)。而动态血压中有杓型变化与无杓型变化者比较 ,其心脑血管并发症的发病率明显降低 ,血压负荷值 >35 %是心脑血管疾病发生的信号。结论 :血压昼夜节律、2 4h总体SBP水平及SBP、DBP负荷值是导致老年高血压并心脑在管疾病发生率高的主要原因

The Relating Study of Blood Pressure load、Elderly Essential Hypertension and Target Organ Damage

Objective: To research the relationship between the change of blood pressure in elderly essential hypertension (EH) patients and target organ damage (TOD) with adopting ambulatory blood pressure monitoring (ABPM). Methods: According to results of ABPM in 86 patients with elderly EH, the patients were randomized into dipper group and nondipper group, the relationship between ambulatory blood pressure and TOD (atrial fibrillation, ventricular arrhythmia, congestive heart failure, cerebrovascular accident) from hypertension was analyzed and compared. Results: There is significant difference between 24h ambulatory avaerage systolic blood pressure (SBP), diastolic blood pressure (DBP) and target organ damage(P< 0.01). It shows significant difference of cerebrovascular accident between average SBP and average DBP at night (P<0.01). The morbidity of cardiovascular and cerebrovascular complications decreases significantly in dpper patients than that in nondipper ones, the load value of blood pressure of more than 35% is a signal of cardiovascular and cerebrovascular complications's occurring. Conclusion:Nyctohemeral rhythm of blood pressure, 24h SBP, load value of SBP and DBP may be regarded as a primary reason of higher morbidity cardiovascular and cerebrovascular complications in patient with elderly EH.