糖脂代谢异常对老年男性高血压患者血压变异性的影响

Effects of impaired glucose and lipoprotein metabolism on blood pressure variability in patients with hypertension

目的探索糖、脂代谢异常对老年男性高血压患者血压变异性(BPV)的影响。方法 120例年龄60岁以上老年男性,其中单纯高血压组40例、高血压合并糖尿病组40例、高血压合并糖、脂代谢异常组40例,共3组。分别对其进行24 h动态血压监测。收集其BPV长时变异性指标,进行对比分析,研究糖、脂代谢异常对高血压患者BPV产生的影响。在高血压合并糖、脂代谢异常组中按TC<5.72 mmol/L及TCl≥5.72 mmoL/L分为非高胆固醇组及高胆固醇组两亚组,分析此两亚组BPV的差异。结果 (1)与单纯高血压组相比,高血压合并糖尿病组、高血压合并糖、脂代谢异常组BPV增大(均为P<0.05);与高血压合并糖尿病组相比,高血压合并糖、脂代谢异常组BPV增大(均为P<0.05)。(2)高胆固醇组较非高胆固醇组BPV增大(均为P<0.05)。结论 (1)高血压合并糖尿病组较单纯高血压组的BPV增大,提示糖代谢异常可能加重高血压患者自主神经功能紊乱。(2)高血压合并糖、脂代谢异常组较高血压合并糖尿病组BPV增大,高胆固醇组较非高胆固醇组BPV增大,提示脂代谢异常可能加重高血压患者自主神经功能紊乱,胆固醇升高可能是其原因之一。

Objective To explore the effects of impaired glucose and lipoprotein metabolism on blood pressure variability （BPV） in elderly male patients with hypertension. Methods One hundred and twenty elderly male patients with essential hypertension （EH） were divided into 3 groups, EH group （ group A, n = 40）, EH with diabetes group （group B, n = 40） and EH with diabetes and impaired lipoprotein metabolism group （group C, n = 40）. Ambulatory blood pressure monitoring （ABPM） were performed in all subjects. BPV was analyzed and compared between different groups. Results BPV in group B and C increased significantly than in group A （ P 〈 0. 05 ） , and BPV in group C increased significantly than in group B （P 〈 0. 05）. In group C, patients with total cholesterol （TC） more than 5.72 mmol/L had higher BPV than those with TC less than 5.72 mmol/L （ P 〈 0. 05 ）. Conclusions Impaired glucose and lipoprotein metabolism can cause significantly increase of BPV in elderly male patients with EH.