老年高血压临床特征及治疗对策

Clinical features and therapeutic methods of elderly hypertension

目的:探讨老年高血压临床特征及治疗对策。方法:将老年高血压组134例与非老年高血压组106例临床资料进行对比分析。结果:①老年组单纯收缩期高血压占47.01%(63/134),明显高于对照组9.43%(10/106),有统计学差异(P=0.000)。②老年组脉压(78.00±16.83)mmHg,明显大于对照组(57.35±19.52)mmHg,有统计学差异(P=0.000)。③晨峰现象老年组占38.06%(51/134),对照组22.64%(24/106),有统计学差异(P=0.01),血压昼夜节律消失老年组占35.08%(47/134),对照组15.09%(16/106),有统计学差异(P=0.000)。④老年组合并血脂异常50.75%(68/134)、糖尿病29.85%(40/134),明显高于对照组35.85%(38/106)、17.92%(19/106),有统计学差异(P<0.05)。⑤老年组并发心血管疾病73.88%(99/134)、脑血管疾病35.08%(47/134)、眼底病变12.69%(17/134),明显多于对照组36.79%(39/106)、21.70%(23/106)、4.72%(5/106),有统计学差异(P<0.05)。结论:老年高血压组收缩压增高,脉压增大,血压波动幅度加大,并发症多;针对老年高血压特点,遵循个体化原则。

Objective： To explore the clinical features and therapeutic methods of elderly hypertension.Methods： Clinical data of 134 old cases with hypertension was analyzed and compared with that of 106 cases without elderly hypertension.Results： ①The incidence rate of systolic hypertension in elderly hypertension group was significantly higher than that in the control group（47.01% vs 9.43%,P=0.000）.②Pulse pressure was significantly higher in elderly hypertension group than that in the control group（78.00±16.83）mmHg vs（57.35±19.52）mmHg,P=0.000）.③There was statistically significant difference in incidence rate of morning-serge（38.06% vs 22.64%,P=0.01）and rhyme change of blood pressure of all the day（35.08% vs 15.09%,P=0.000） between elderly hypertension group and the control group.④There was statistically significant difference in combination rate of hyperlipidemia（50.75% vs 35.85%）and diabetes（29.85% vs 17.92%）.⑤There was statistically significant difference in incidence rate of cardio-vascular diseases（73.88% vs 36.79%）,cerebro-vascular disease（35.08% vs 21.70%）and eyeground pathology（12.69% vs 4.72%）.Conclusion： In elderly hypertension group,the systolic pressure,pulse pressure and fluctuation range of blood pressure increased and there were a lot of target organ damage and complications. According to the clinical features of elderly hypertension,treating targets should follow individual method.