老年高血压异常夜间血压下降的临床意义

Clinical Significance of Abnormal Nocturnal Blood Pressure Falls in the Senile Hypertension

目的观察持续老年高血压病人夜间收缩压下降杓类型对心脑损伤影响。方法应用ABPM检测105例病人,以夜间收缩压下降再分类下降≥20％定义ED,≥10％而<20％为D,≥0％而<10％为ND,<0％为RD。结果ED10例(9.52％),D31例(29.52％),ND44例(41.90％),RD20例(19.04％)。四组脑梗死(包括腔隙性梗死)发生率分别为60.00％,22.38％,43.18％和55.00％。左室肥厚和CHD发生率,RD组远较其它组高。结论夜间收缩压下降类型对脑卒中,左室肥厚和冠心病发生起重要作用。

Objective To investigate the relation between nocturnal systolic blood pressure ( SBP ) fall pattern and hypertensive heart, brain damage in senile patient with sustained hypertension. Methods The SBP of 105 cases without medication was determined by ambulatory blood pressure monitoring (ABPM). All patients were subclassified into 4 groups by their nocturnal systolic blood pressure fall: Extreme dippers(ED): >20% ; Dippers(D): 10% -20% ; Nondippers(ND): 0% - 10% ; Reverse dippers(RD): <0% . Results Cases of every group were as follows. ED:10(9. 50%) , D:31(29. 50%), ND: 44 (41.90 %),RD:20(19.10%). The rate of cerebral infarction in 4 groups was 60% in ED, 55% in RD, 22.38% in D and 43.18 % in ND. The rate of left ventricular hypertrophy and CHD in RD group is higher than other groups. Conclusions Abnormal dipping patterns of nocturnal SBP play an important role in the senile hypertensive organ damage.