摘要
目的了解住院老年高血压患者血压、脉压和靶器官损害对生存和预后的影响,为老年高血压的预后判断提供临床依据。方法采用流行病学回顾性调查的方法,对19996例年龄≥60岁住院高血压存活(17682例)、死亡(2314例)患者的一般情况、病史和合并靶器官等进行回顾性总结分析。结果高血压存活患者的年龄、体重指数、收缩压、舒张压和脉压与死亡患者比较差异均有统计学意义(P<0.05,P<0.01)。高血压存活和死亡患者血压的达标率分别54.1%和40.3%,其中收缩压达标者在存活和死亡患者分别为61.4%和54.1%,舒张压达标者在存活和死亡患者分别为66.9%和75.9%。老年高血压存活患者并发糖尿病的发生率最高,而死亡患者并发脑血管疾病的发生率最高,同时造成老年高血压患者死亡风险最高的疾病为多器官功能衰竭(RR=27.63,95% CI:0.03～56.52,P<0.01),其次为尿毒症(RR=8.16,95% CI:4.11～11.36,P<0.01)和心功能不全(RR=4.81,95% CI:1.69～5.31,P<0.01)。结论老年高血压死亡患者靶器官损害发生率明显高于存活患者,以多器官功能衰竭更为显著;血压控制达标率低,且脉压差和年龄大。
Objective To assess the influence of blood pressure, pulse pressure and target organ damage（TOD） on the survival and prognosis of elderly patients with hypertension,in order to provide clinical evidence for the judgement of prognosis of these patients. Methods Retrospective survey was used to summarize and analyze the general state of health,medical history and complications of target organs in 19 996 inpatients aged over 60 with hypertension,of whom, 17 682 are survival,the other 2314 were dead. Results The age, BMI, systolic, diastolic and pulse pressures of the survival were significantly different from those of the dead group. The rates of achieving target blood pressure were 54.1% fro and 40.3 % in survival and dead groups respectively. The rates of achieving target systolic pressure were 61.4% and 54.1% ,and rates of achieving target dias- tolic pressure were 66.9 % and 75.9 %. Survival patients had the highest incidence of diabetes,and dead patients displayed the highest cerebrovascular disease rate. The highest risk that caused the death of elderly patients with hypertension was multiple organ failure （RR = 27. 63,95% CI ：0. 03--56. 52, P〈 0. 01） , followed by uremia （RR = 8.16,95%0 CI .4.11--11.36, P 〈 0.01）, and then the cardiac dysfunction （RR = 4.81,950/00 CI ：1.69-5.31, P 〈 0.01）. Conclusions The incidence of TOD,especially multiple organ failure,in the dead group is significantly higher than that in the survival group. The rate of blood pressure under control in dead group is lower than that in the survival group, while their pulse pressure and age are higher.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2010年第7期587-589,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
高血压
血压
心血管疾病
脑血管障碍
肾功能不全
预后
hypertension
blood pressure
cardiovascular diseases
cerebrovascular disorders
renal insufficiency
prognosis
