老年高血压病的临床特点分析(附170例报告)

目的:探讨24h动态血压监测对老年高血压病诊断及预后判断的意义。方法:对170例于本科门诊或病房经观察偶测血压,按1999年WHOISH高血压分类标准,确诊为高血压病老年患者实施24h动态血压监测,根据动态血压结果,剔除白大衣性高血压〔1〕,及诊断依据不充分的患者。将确定无疑的高血压病患者动态血压指标进行分析研究。结果:老年单纯收缩期高血压病占全部高血压病的12.5%。单纯收缩期高血压病患者的靶器官损害发生率明显高于非单纯收缩期高血压病患者,非单纯收缩期高血压病例中,血压昼夜节律消失组靶器官损害发生率亦显著高于血压昼夜节律存在组。结论:动态血压监测是正确诊断高血压病的必要选择,老年高血压病中单纯收缩期高血压病患者及血压昼夜节律消失者占较大比例,并有更加严重的靶器官损害。

Analysis on the Clinical Characteristics in elderly Hypertension

Objective: To evaluate the diagnosis and prognosis of 24-hour ambulatory blood pressure monitoring(ABPM) in elderly Hypertension. Method:By the 1999 WHO/ISH hypertension separate criteria, one hundred and seventy patients diagnosed the elderly hypertension in out-patient clinic and ward of a hospital was carried out 24-hour ABPM. According to the results, patients with white coat hypertension and whose conditions are not enough to the criteria were excluded. Then we evaluate the ambulatory blood pressure index in the definitely diagnosed elderly hypertension. Results:The elderly isolated systolic hypertension is 12.5 percent of the whole hypertensive patients. The incidence of the target organ damage in the isolated systolic hypertension is much higher that of the no- isolated systolic hypertensions. In no- isolated systolic hypertension patients, the target organ damage incidence rate in the group with no circadian rhythm is much higher than that of the group with circadian rhythm. Conclusion:ABPM is necessary to diagnose the hypertension. The elderly hypertension mainly concludes the isolated systolic hypertension and those with no circadian rhythm and the target organ damage of the two kinds are much more severe.