摘要
目的 探讨老年原发性高血压住院患者血压昼夜节律与血管僵硬度的相关性。方法 回顾性分析2022年1月至2023年6月于中国人民解放军总医院住院的440例老年原发性高血压患者的临床资料。收集患者一般资料、用药史、生化检测指标、动态血压监测(ABPM)及肱-踝动脉脉搏波传导速度(baPWV)数据。将患者分为baPWV正常组(<1 400 cm/s,n=108)、baPWV低危组(1 400~<1 800 cm/s,n=200)和baPWV高危组(≥1 800 cm/s,n=132)。采用SPSS 27.0统计软件进行数据分析。根据数据类型,分别采用t检验、单因素方差分析、Mann-Whitney U检验或χ^(2)检验进行组间比较。采用logistic回归分析导致老年高血压住院患者血管僵硬度增高的危险因素。构建血管老化风险预测模型,并采用受试者工作特征(ROC)曲线评价模型预测效力。结果 440例老年高血压患者,年龄(68.6±6.4)岁,其中男性235例(53.4%)。高危组患者年龄、24 h收缩压、日间收缩压、夜间收缩压、空腹血糖及糖化血红蛋白水平明显高于正常组和低危组;低危组和高危组24 h舒张压、日间舒张压、夜间舒张压、24 h收缩压标准差及日间收缩压标准差均显著高于正常组,差异有统计学意义(P<0.05)。趋势卡方检验结果提示,血管僵硬度增高的患者反勺型血压模式比例明显增加,差异有统计学意义(χ^(2)=17.626,r=0.168;P<0.01)。多因素logistic回归分析显示,年龄(OR=1.112,95%CI 1.070~1.156;P<0.001)、体质量指数(BMI)(OR=0.870,95%CI 0.797~0.950;P=0.002)、空腹血糖(OR=1.201,95%CI 1.071~1.347;P=0.002)、24 h平均收缩压(OR=0.574,95%CI 0.409~0.806;P=0.001)、日间平均收缩压(OR=1.599,95%CI 1.242~2.058;P<0.001)、夜间平均收缩压(OR=1.157,95%CI 1.052~1.273;P=0.003)及反勺型血压模式(OR=2.435,95%CI 1.306~4.540;P=0.005)是baPWV升高的独立危险因素。纳入上述七项指标构建血管老化风险预测模型,其受试者工作特征曲线下面积为0.804,模型预测效能�
Objective To investigate the correlation between circadian rhythm of blood pressure and vascular stiffness in elderly hospitalized patients with essential hypertension(EH).Methods The clinical data of 440 elderly EH patients admitted in Chinese PLA General Hospital from January 2022 to June 2023 were retrospectively analyzed.Their general information,medication history,biochemical test indicators,and results of ambulatory blood pressure monitoring(ABPM)and brachial-ankle pulse wave velocity(baPWV)were collected.According to the baPWV value,these patients were divided into normal(<1400 cm/s,n=108),low-risk(1400-<1800 cm/s,n=200),and high-risk(≥1800 cm/s,n=132)groups.SPSS statistics 27.0 was used for data analysis.Depending on data type,student′s t test,one-way ANOVA,Mann-Whitney U test,or Chi-square test was employed for intergroup comparisons.Logistic regression analysis was applied to identify the risk factors for increased vascular stiffness in elderly EH inpatients.A vascular aging risk prediction model was constructed,and its predictive performance was evaluated using receiver operating characteristic(ROC)curve analysis.Results Among the 440 elderly EH patients,their average age was(68.6±6.4)years,and there were 235(53.4%)male cases.The age,24h systolic blood pressure(SBP),daytime SBP,nighttime SBP,fasting blood glucose(FBG)and glycosylated hemoglobin A1c of patients in the high-risk group were significantly higher than those in the normal and low-risk groups;24 h diastolic blood pressure(DBP),daytime DBP,nighttime DBP,standard deviation of 24hSBP and daytime SBP of patients in the low-and high-risk groups were significantly higher than those in the normal group,and the difference was statistically significant(P<0.05).Trend Chi-square test showed that the proportion of reverse dipper pattern was increased significantly in the patients with increased vascular stiffness(χ^(2)=17.626,r=0.168;P<0.01).Multivariate logistic regression analysis indicated that age(OR=1.112,95%CI 1.070-1.156;P<0.001),body mass i
作者
傅猛
陈仁政
王亚斌
沈晓影
元媛
刘建伟
谷政慧
房之沂
范利
曹丰
Fu Meng;Chen Renzheng;Wang Yabin;Shen Xiaoying;Yuan Yuan;Liu Jianwei;Gu Zhenghui;Fang Zhiyi;Fan Li;Cao Feng(Medical School of Chinese PLA,Beijing 100853,China;Department of Cardiology,Second Medical Centre,National Clinical Medical Research Centre for Geriatric Diseases,Chinese PLA General Hospital,Beijing 100853,China)
出处
《中华老年多器官疾病杂志》
2024年第6期401-406,共6页
Chinese Journal of Multiple Organ Diseases in the Elderly
基金
科技部重点研发计划(2022YFC3602400)。
关键词
老年人
原发性高血压
动态血压监测
血管僵硬度
脉搏波传导速度
aged
essential hypertension
ambulatory blood pressure monitoring
vascular stiffness
pulse wave velocity
