动态血压变异性与老年原发性高血压左室肥厚的关系

目的探讨动态血压各参数的变异性与老年高血压左室肥厚的关系。方法采用动态血压、超声心动图检查142例年龄大于65岁的原发性高血压患者,其中81例无左室肥厚,61例有左室肥厚, 对两组动态血压参数进行组间比较及昼夜间比较,并对各参数与左室质量指数(LVMI)进行相关性分析。结果①昼、夜收缩压水平、脉压与LVMI呈强相关,左室肥厚组的收缩压、舒张压水平及脉压明显高于无左室肥厚组；②两组之间血压变异无差异；③所有患者收缩压变异大于舒张压变异,收缩压变异白昼大于夜间,而昼夜间舒张压变异、脉压水平改变不明显。结论老年高血压患者左室肥厚与血压变异相关性较小,主要与收缩压水平与脉压水平相关,老年高血压患者24h舒张压变异与脉压水平处于相对恒定的水平,脉压可能是预测老年高血压性左室肥厚的一个简便易行的指标。

Clinical study on relationship between blood pressure variability and left ventricular hypertrophy in elderly with essential hypertension

Objective To explore the relationship beween blood pressure variability with left ventricular hypertrophy (LVH).Methods Echocardiography and ambulatory blood pressure monitoring (ABPM)were performed in 142 essential hypertension patients who were over 65 years old. They were divided into two groups, including 81 cases without LVH group and 61 cases with LVH group. Blood pressure parameters between the two groups, and between daytime and nighttime in each group were compared. Correlation of each parameter of BPM and left ventricular mass index (LVMI)was analyzed. Results ①There was significant correlation between systolic blood pressure (SBP) and PP and LVMI. In LVH group, SBP, diastolie blood pressure (DBP)and PP were obviously higher than those in non-LVH group. ②There was no difference in blood pressure variability between the two groups. ③Variability of SBP was higher than of DBP and variability of daytime SBP higher than that of nighttime SBP while the variability in DBP and PP were not obvious between daytime and nighttime in all cases. Conclusion The correlation between LVH and BPV is relatively small in elderly hypertension patients. It is mainly correlated with SBPand PP level. The 24 DBP variability and PP are kept relatively stable level, so PP may be used as a convenient index to predict LVH in elderly hypertension patients.