老年高血压合并体位性低血压患者靶器官损害及最佳血压水平的研究

目的研究老年高血压合并体位性低血压患者靶器官损害情况及最佳的血压水平。方法选取2010年3月~7月进行体检的长期居住广州的军队离退休老干部中的原发性高血压患者849例,对其进行健康问卷调查,并测量卧位及立位后0、2 min血压和心率,对体位性低血压的发生率进行统计,同时分析体位性低血压组与非体位性低血压组患者靶器官损害情况。结果老年高血压患者体位性低血压的发生率随着高血压分级升高而增加;体位性低血压组的左室肥厚及微量白蛋白尿的发生率均高于非体位性低血压组;血压控制在130~139/70~79 mm Hg时体位性低血压的发生率最低。结论老年高血压合并体位性低血压发生靶器官损害的危险较高,130~139/70~79 mm Hg可能是老年高血压合并体位性低血压患者最佳的血压范围。

The study of appropriate blood pressure in the elderly population with hypertension and orthostatic hypotension

Objective To determine appropriate blood pressure in the elderly population with hypertension and orthostatic hypotension. Methods A total of 849 elderly and retired hypertensives who underwent health screening physical examination in Guangzhou Military Region were included. Orthostatic blood pressure and heart rate were measured in THE supine position after resting for more than 5 minutes and at 0 and 2 min after standing. A Comparative analysis was conducted on the prevalence of OH. Results Significant differences of the prevalence of OH were observed in patients with different blood pressures. Patients with orthostatic hypotension more commonly had left ventricular hypertrophy (54.4% vs 44.6% ,P = 0.01)and a high rate of microalbuminuria (46.4% vs 36.9%,P = 0.01)than did those with orthostatic normotension. By analyzing current blood pressure control,the following results were obtained:individuals with a systolic blood pressure ranging from 130-139 mmHg and/or a diastolic blood pressure ranging from 70-79 mmHg had a significantly lower prevalence of OH (21.4% vs 23.8%;P < 0.05). Conclusion Elderly patients with essential hypertension with orthostatic hypotension have evident target organ damage. A systolic blood pressure ranging from 130 to 139 mmHg and/or a diastolic blood pressure ranging from 70 to 79 mmHg might be an appropriate blood pressure goal for patients with hypertension and orthostatic hypotension.