老年高血压病患者血压节律与靶器官损害的相关性

Relationship between circadian variation of blood pressure and target organ damage in the elderly with essential hypertension

目的探讨老年高血压病患者血压节律变化与心、脑、肾等靶器官损害的相关性。方法观察高血压病血压节律正常（杓型组）和异常（非杓型组）２组老年患者各３８例的临床资料。结果组间在体重指数、偶测血压、白昼平均收缩压等无显著差异（Ｐ＞０．０５）；非杓型组２４ｈ平均收缩压和舒张压、白昼平均舒张压、夜间平均收缩压和舒张压、收缩压和舒张压负荷值较杓型组升高（Ｐ＜０．０５～０．０１）；左室重量和左室重量指数显著增加（Ｐ＜０．０５，０．０１）；无症状腔隙性脑梗塞的个数及发病率均高于后者（Ｐ均＜０．０５）；无痛性心肌缺血次数增多，总持续时间延长（Ｐ＜０．０１，０．０５）；尿蛋白检出率亦高于后者（Ｐ＜０．０１）。结论血压昼夜节律消失较节律正常的高血压病患者有更显著的靶器官损害。

Objective To study the relation between the circadian variation of blood pressure and target organ damage in the elderly with essential hypertension Methods Clinical characteristics were compared between 38 essential hypertensives(EH)without circadian rhythm in blood pressure(non dipper gruop)and 38 EH with normal circadian variation (dipper group) Results There were no significant differences in the BMI,CSBP,CDBP,dSBP( P >0 05);The hypertensives in the non dipper group had higher values of 24hSBP,24hDBP,dDBP,nSBP,nDBP,SBP L and DBP L than those in the dipper group( P <0 05～0 01);the LVM and LVMI levels of the non dipper group were significatly increased ( P <0 05,0 01;respectively).Both the number and the incidence of silent lacuna infarction in the non dipper group were higher than those in the dipper group( P <0 05,rspectively).The number of silent myocardial ischemia was higher and the time longer in the non dipper group( P <0 01,0 05;respectively);the incidence of urine protein was also higher than that of the dipper group Conclusions Essential hypertensives without circadian variation in blood pressure may be accompanied with more target organ damages.