老老年人群动态血压参数与动脉僵硬度的相关性

Relation between ambulatory blood pressure and arterial stiffness in the very elderly

目的探讨老老年人群动态血压参数与动脉僵硬度的相关性。方法筛选年龄≥80岁的老老年人238例,以血压≥160/95 mm Hg(1 mm Hg=0.133 kPa)为标准,分为高血压组(134例)和对照组(104例),并进行臂-踝脉搏传导速度(baPWV)和24 h动态血压监测。用Pearson分析动态血压各参数与动脉僵硬度的相关性。结果高血压组baPWV高于对照组(P<0.05)。高血压组偶测收缩压,24 h、昼间和夜间收缩压、舒张压、脉压,收缩压负荷及舒张压负荷均高于对照组.夜间收缩压下降率、舒张压下降率低于对照组,差异有统计学意义(P<0.05,P<0.01)。baPWV与偶测血压;24 h收缩压、舒张压、脉压;昼间收缩压、舒张压、脉压、心率;夜间收缩压、舒张压、脉压;收缩压负荷、舒张压负荷呈正相关(P<0.05,P<0.01),而与夜间收缩压下降率呈负相关(P<0.01)。结论高血压是老老年人群动脉僵硬度增加的一个重要因素,动脉僵硬度与动态血压、脉压、心率及血压负荷相关。

Objective To investigate the relation between ambulatory blood pressure and arterial stiffness in the very elderly. Methods 238 very elderly（age≥80 years） were divided into two groups：104 normotensive and 134 hypertensive（BP≥160/95 mm Hg, 1 mm Hg=0. 133 kPa）. Ambulatory blood pressure and brachial-ankle pulse wave velocity（baPWV） were monitored for all subjects. The relationship between parameters of ambulatory blood pressure and arterial stiffness was analyzed by Pearson correlation. Results The baPWV of the hypertensive group was significantly higher than that of normotensive group （P 〈 0.05,P 〈 0.01）. The casual systolic blood pressure（SBP）,24 h,day（D） and night（N） SBP,diastolic blood pressure（DBP）,pulse pressure（PP） ,SBP load and DBP load in hypertensive group were significantly higher than those in the normotensive group. The rates of nocturnal SBP decrease and DBP decrease in the hyperten- sive group were significantly lower than those in the normotensives （P 〈 0.05 ,P 〈 0.01）. Pearson correlation analysis showed that baPWV was positively correlated with casual SBP, casual DBP, 24 h SBP, DBP, PP ; day SBP, DBP, PP, HR ; night SBP, DBP, PP, SBP load and DBP load, negatively correlated with night SBP decrease （P 〈 0.01）. Conclusion Present findings suggest that increase in arterial stiffness is an important factor of hypertension in the very elderly. Arterial stiffness is correlated with ambulatory SBP,DBP,PP,HR and BP load.