高龄高血压患者血压昼夜节律改变与左室肥厚的关系

Relationship between circadian rhythm of blood pressure and left ventricular hypertrophy in elderly patients with essential hypertension

目的:探讨高龄高血压患者动态血压昼夜节律改变与左室肥厚的关系。方法:对186例年龄≥75岁的高血压病患者进行动态血压监测,并应用超声心动图检测左室舒张末期内径、舒张期室间隔厚度、左心室后壁厚度,计算左心室重量及左心室重量指数。观察血压昼夜节律变化及左室结构的变化。结果:动态血压监测显示24h血压呈非勺型者为142例(76.34%),呈勺型者为44例(23.66%),非勺型组24h收缩压、舒张压均高于勺型组(P<0.01)。非勺型组室间隔厚度、左心室后壁厚度、左心室重量指数均较勺型组增加(P<0.05,<0.05,<0.01)。结论:高龄高血压患者70%以上血压昼夜节律失常,且左室肥厚的发生率明显增加。

Objective： To ascertain the associations between the circadian rhythm of blood pressure （BP）and left ventricular hypertrophy in elderly patients with essential hypertension （EH）. Methods： The 186 patients （≥75years old） with hypertension were selected for ambulatory blood pressure monitoring （ABPM） of 24 h. LVEDd, IVSTD and PWT were measured by echocardiography, LVM and LVMI were calculated. To observe circadian rhythm of BP and structure changes of left ventricular. Results： Non-dipper BP was 142 cases （76.34%） and dipper BP was 44 cases （23.66%） by ABPM monitoring. SBP and DBP of 24 h, IVST, PWT and LVMI were higher in non-dipper group than those of dipper group （P〈0.05 ～ 〈0. 01）. Conclusion： The circadian rhythm of blood presurre is abnormal in eider EH patients more than 75 %, and the occurrence of left ventricular hypertrophy significantly increase in non-dipper EH patients.