高龄老年高血压患者动态血压和动态心电图特点及临床分析

Analysis of ambulatory blood pressure,ambulatory ECG and clinical characteristics in very old patients with hypertension

目的分析高血压患者的24h动态血压、心电图的特点，并结合临床分析，为临床高龄老年高血压防治提供可参考依据。方法共入选老年高血压患者214例，按年龄分为两组，A组：高龄老年组（≥80岁）96例；B组：低龄老年组（60～79岁）118例。采用24h动态血压和24h动态心电图同步监测技术，记录血压和心电图变化，同时采集多次住院病历，观察高血压患者治疗过程中血压控制情况，心律失常以及靶器官损害发生情况。结果高龄老年组的大部分患者血压控制良好。24h动态血压水平两组之间仍有明显差异，高龄老年组心律失常、心脑血管事件次数、糖尿病、体重指数、左心室重量指数等均显著高于低龄老年组。结论与低龄老年组相比，80岁以上的高龄老年高血压患者肾损害明显，其24h动态血压水平与动态心电图改变及肾损害之间密切相关。

Objective To analyze the 24h ambulatory blood pressure, 24h ambulatory ECG and clinical characteristics in very old patients with hypertension in order to provide basis for clinical medical therapy of hypertension. Methods A total of 214 patients with hypertension were divided into two groups according their ages. Twenty four hours ambulatory blood pressure monitoring and 24h ambulatory ECG were adapted and information of their present and past clinical records was collected to examine the occurrence of target organ damages. Results Though blood pressures of patients aged higher than 80 were well controlled in majority of the patients with their 24h systolic pressure, diastolic pressure and pulse pressure being within normal ranges, their blood pressure indexes were significantly higher than those in another group. The rates of occurrence of arrhythmia,cardio-cerebral vascular events, diabetes mellitus and previous angiocardiopathy were significantly higher in patients aged higher than 80 years. Body mass index and left ventricle mass index were also higher in patients aged higher than 80 years. Conclusion The target organs are damaged significantly in very old patients with hypertension. There is a close correlation between the level of 24h ambulatory blood pressure, the change of dynamic ECG and renal damage in very old patients with hypertension.