老年高血压患者昼夜血压节律对颈总动脉IMT的影响

Influence of circadian rhythm on common carotid artery intima-media thickness in very elderly patients with hypertension

目的观察≥80岁高血压患者昼夜血压节律对颈总动脉内膜-中层厚度(IMT)的影响。方法应用24h动态血压监测仪监测68例年龄≥80岁的高血压患者的昼夜血压节律,根据夜间血压下降率将其分为2组,夜间血压下降率<10%为非杓型组,≥10%为杓型组。彩色多普勒超声诊断仪测定2组患者IMT。结果非杓型组24h收缩压、24h舒张压、夜间收缩压、夜间舒张压明显高于杓型组(P<0·01)。非杓型组IMT比杓型组明显增加(P<0·01)。结论非杓型血压节律的老年高血压患者较杓型血压节律者的颈总动脉的粥样硬化程度更明显。

Objective To investigate the influence of circadian rhythm on common carotid artery intima-media thickness（IMT） in very elderly patients with hypertension. Methods Sixty-eight elderly patients （ ≥80 years old） with hypertension were divided into two groups according to their blood pressure-decreasing rate at night（ 〈 10% into non-dipper group, ≥ 10% into dipper group）. The circadian rhythm, IMT of these patients were measured respectively with ambulatory blood pressure monitor and echocardiography. Results 24 h SBP, 24 h DBP, night SBP and night DBP were significantly higher in non-dipper group than those in dipper group（ P 〈 0. 01 ）. IMT of the patients in non-dipper group was significantly increased compared with dipper group （ P 〈 0. 01 ）. Conclusions The atherosclerotic development of the common carotid artery is more serious in very elderly hypertensive patients with non-dipper circadian rhythm than that in hypertensive patients with dipper circadian rhythm.