摘要
目的分析老年原发性高血压患者动态血压的昼夜节律特征及其临床意义,探讨老年高血压患者的血压控制策略。方法选择476名老年原发性高血压患者进行24 h动态血压监测,分析其24 h、白天、夜间平均血压和平均脉压及血压变异性。结果老年高血压患者血压均值收缩压(SBP)和血压均值舒张压(DBP)的波动曲线均呈"双峰双谷"状,血压节律呈非杓型者382例,杓型者94例。老年组和高龄组的非杓型高血压检出率分别为73.47%和91.21%,非杓型高血压检出率在不同年龄组间的差异有统计学意义,但在不同性别间的差异无统计学意义。老年高血压患者的24 h动态血压监测(ABPM)参数在男女间无显著性差异,高龄组的24 h SBP、d SBP、24 h APP高于老年组的24 h SBP、d SBP、24 h APP,组间差异有统计学意义。结论老年高血压患者血压昼夜节律呈现非杓型高血压表现为主的异常改变,表现为以单纯收缩压增高为主、舒张压不高甚至降低、脉压增大;且随年龄增高,这些血压异常改变的特征更趋显著。24 h动态血压监测可为不同血压波动类型的老年高血压患者实施更精细的个体化防治方案提供更有效指导。
[Objective]To analyze the circadian rhythm features of blood pressure in aged patients with primary hypertension, study its clinical significance, and explore the blood pressure control strategy in aged patients with hypertension. [Methods]24-hour ambulatory blood presstlre monitoring was performed in 476 aged patients/~vith primary hypertension, to analyze the blood pressure, pulse pressure and blood pressure variability during 24 hours, daytime and night.[Results]The systolic blood pressure （SBP） and diastolic blood pressure （DBP） of aged patients with hypertension showed the fluctuation curve of double peak to valley. There were 382 cases of non-dipper hypertension and 94 cases of dipper hypertension. The detection rate of non-dipper hypertension in the elderly group and the advanced age group was respectively 73.47% and 91.21%, and there was statistically significant difference in the detection rate of non-dipper hypertension among different age groups, while the difference between men and women was not statistically significant. There was no statistically significant difference in 24-hour ambulatory blood pressure monitoring （ABPM） parameter between gender groups. The levels of 24 hSBP, dSBP and 24 hAPP in the advanced age group were higher than those in the elderly group, and the differences were statistically significant. [Conclusion]The circadian rhythm of blood pressure in aged patients with hypertension shows the abnormal change which is dominated by the non-dipper hypertension, that is the systolic blood pressure increase, while the diastolic blood pressure decrease or dose not increase, and pulse pressure increase. The features of blood pressure change significantly with the increasing of age. 24-hour ambulatory blood pressure monitoring can provide the effective guidance for implementing the individual control schemes among aged hypertension patients with different features of circadian rhythm.
出处
《职业与健康》
CAS
2015年第10期1337-1339,1343,共4页
Occupation and Health
基金
2012年度广州市海珠区医疗卫生指导性科技计划项目(项目编号:2012-y1-09)
关键词
老年高血压
动态血压监测
昼夜节律
Aged patients with hypertension
Ambulatory blood pressure monitoring
Circadian rhythm
