摘要
目的探讨老年原发性高血压(EH)患者静息心率(RHR)与靶器官损害的关系。方法入选老年EH患者206例,按RHR水平分为RHR1组<70次/min(56例),RHR2组70次≤RHR<80次/min(84例),RHR3组RHR≥80次(66例)三组。对人选患者做以下检查心电图、超声心动图、颈动脉超声、肌酐清除率以及尿微量白蛋白。结果(1)RHR2组和RHR3组的颈动脉内膜厚度(IMT)、颈动脉内径(CAD)、左心室重量指数(LVMI)以及尿微量白蛋白定量(MAU)均高于RHR1组(P<0.01),而左室射血分数(LVEF)、肌酐清除率小于RHR1组(P<0.01)。(2)RHR与IMT、CAD、LVMI、MAU呈正相关(r分别为0.312、0.289、0.630、0.576,P<0.01),而与LVEF、肌酐清除率呈负相关(r分别为-0.563、-0.510,P<0.01)。(3)非条件Logistic回归分析显示,RHR、收缩压(SBP)、舒张压(DBP)、脉压(PP)对高血压性心脏病、冠心病、心力衰竭、脑血管意外和肾功能损害有不同程度的影响(P<0.05或P<0.01),其中SBP和RHR的作用更大。结论RHR可能是老年EH患者靶器官损害的独立危险因素。
Objective To investigate the relationship between resting heart rate(RHR)and target organs damage (TOD) in senile essential hypertension.Methods 206 elderly patients with essential hypertension were divided into three groups according to the level of RHR 〔RHR1 group: RHR<70 beats/minute (bpm)(56 cases); RHR2 group: 70 bpm≤RHR<80 bpm (84 cases); RHR3 group: RHR≥80 bpm (66 cases). Electrocardiography, carotid ultrasonography, echocardiography, creatinine clearance rate (CCr) and quantitative test for 24 hours' urinary microalbuminuria (MAU) were performed. Results (1) Compared with RHR1 group, the RHR2 group and RHR3 group showed higher levels of carotid intima-medial thickness (IMT), carotid arterial diameter (CAD) and left ventricular mass index (LVMI), lower levels of left ventricular ejection fraction (LVEF) and MAU (all P<0.01). (2) The levels of IMT, CAD, LVMI and MAU were positively correlated to RHR(r=0.312, 0.289, 0.630, 0.563, 0.576 respectively, all P<0.01). However, the levels of LVEF and CCr were negatively correlated to RHR (r=-0.563,-0.510,all P<0.01). (3) Logistic multivariate analysis showed that RHR, pulse pressure(PP), systolic blood pressure (SBP) and diastolic blood pressure (DBP) influenced TOD such as hypertensive heart disease, coronary heart disease, heart failure, cerebral stroke and renal damage in different degrees, among them, PP and RHR played more important roles than those of other factors. Conclusions RHR is one of the important independent risk factors of TOD in senile essential hypertension.
出处
《中国老年学杂志》
CAS
CSCD
北大核心
2005年第1期7-9,共3页
Chinese Journal of Gerontology
关键词
高血压
静息心率
靶器官损害
老年人
Hypertension
Resting heart rate (RHR)
Target organs damage (TOD)
Senile
