脉压对老年高血压病患者左心室肥厚的影响

目的　比较动态脉压和诊所脉压对老年高血压病患者左心室肥厚的影响。方法　选择初诊的轻 中度高血压病患者 118例。所有入选病例测量非同日 3次诊所血压、进行 2 4h动态血压监测和超声心动图检查。根据动态脉压和诊所脉压水平各分为 3组 ,并分别比较。结果　动态脉压与年龄、高血压病史、左心室重量指数、动脉僵硬度指数和体重指数呈显著的相关性。动脉僵硬度随分组脉压的增大呈显著递增 ,其与动态脉压的相关性明显强于诊所脉压。动态脉压与左心室重量指数的相关性明显强于诊所脉压。结论　脉压升高是老年高血压病患者左心室肥厚的重要危险因素 ,与诊所脉压比较 ,动态脉压更能反映高血压靶器官损害的程度。

Impact of pulse pressure on left ventricular hypertrophy in senile patients with essential hypertension

Objective To investigate and compare the impact of ambulatory pulse pressure(APP) and clinic pulse pressure(CPP) on left ventricular hypertrophy(LVH) in senile patients with essential hypertension.Methods 118 initially untreated subjects with mild to moderate essential hypertension were enrolled in this study. All subjects underwent 3 blood pressure measurements on different days, ambulatory blood pressure monitoring and echocardiography. They were divided into three groups according to their APP and CPP levels,respectively,to observe and compare the impact of APP and CPP on LVH.Results APP was significantly correlated with age, history of hypertension, LVMI(left ventricular mass index), ASI(arterial stiffness index) and BMI(body mass index). Arterial stiffness evolved progressively with increase in pulse pressure, and it correlated with APP much better than with CPP. APP correlated with LVMI much stronger than CPP did. ConclusionThe increase in pulse pressure was the important determinant of LVH in senile patients with essential hypertension. Compared with CPP,APP provided a more precise estimate of target organ damage in hypertensives.