老年原发性高血压患者血压晨峰现象对靶器官影响的临床研究

Influence of morning blood pressure surge on target organs in elderly patients with essential hypertension

目的研究老年原发性高血压患者血压晨峰现象,明确其对主要靶器官结构及功能的潜在损害。方法采用24h动态血压监测仪分析88例老年高血压患者的血压,确认晨峰组与非晨峰组,均常规检查血脂、空腹血糖、测定尿微量白蛋白(UALB),计算体质量指数(BMI)、左心室质量指数(LVMI)、心电图计算QT离散度(QTcd)。结果晨峰组的24h白昼、夜间平均收缩压均显著高于非晨峰组动态血压监测水平,晨峰组的LVMI、QTcd和UALB指标均高于非晨峰组(P<0·05);2组BMI、血脂、血糖差异无统计学意义(P>0·05)。结论血压晨峰使靶器官损害增加,因此遏制原发性高血压患者的晨峰反应对降压达标和减缓靶器官受累程度具有重要意义。

Objective To investigate the influence of morning blood pressure surge on target organs in elderly patients with essential hypertension. Methods According to 24 h ambulatory blood pressure monitoring profiles, 88 cases were divided into morning blood pressure surge group （ surge group） and morning blood pressure normal group （ normal group）. The levels of cholesterol, microallbuminuria, body mass index（ BMI）, left ventrieular mass index（LVMI） and QT dispersion（QTed） were detected. Results The blood pressure of whole day, day and night in surge group were significantly higher than those in normal group. Morning systolic blood pressure variability was significantly higher. LVMI, QTed and mieroalbuminuria in surge group were higher than those in normal group（ P 〈 0.05 ）. There was no difference between two groups in age, BMI （P 〉 0. 05 ）. Conclusions Morning blood pressure is an important risk factor in elderly patients with hypertension. Morning blood pressure surge can damage the heart, kidney and blood vessel function. Lowering the morning surge is a sensible way in hypertension management.