老年男性高血压患者降压治疗后血压变异性与心室重构的相关性研究

Correlations between blood pressure variability and ventricular remolding in elderly men with hypertension treated by antihypertensive agents

目的探讨老年男性高血压患者降压治疗后动态血压变异性与心室重构的关系。方法入选老年男性原发性高血压患者212例(高血压组),均单用长效钙通道阻滞剂降压治疗超过1年,行动态血压监测(ABPM),根据24h收缩压平均实际变异性(24 hSBP AVR)的第50百分位数(P50)将高血压组分为两组:高AVR组(AVR≥10.17 mmHg)和低AVR组(AVR<10.17 mmHg),各106例。另入选48例同期年龄相匹配的非高血压老年男性患者为对照组。测定入选患者所有血压水平、24 hSBP AVR等血压变异性指标及舒张期室间隔厚度(IVST)、舒张期左心室后壁厚度(LVPWT)、左心室舒张末内径(LVEDd),计算左心室质量指数(LVMI),比较各组差异。结果与对照组比较,高血压组24 h、日间及夜间平均收缩压,24 hSBP AVR值均高于对照组(P<0.05),高AVR组IVST及IVEDd高于低AVR组(P<0.05)。相关分析显示,LVMI与24 hSBP(r=0.361,P<0.05)及24 hSBP AVR(r=0.210,P<0.05)呈正相关。结论老年男性原发性高血压患者降压治疗后收缩压水平及收缩压变异性与左心室重构有关。

Objective To investigate the correlations between blood pressure variability （BPV） and ventric- ular remolding in elderly men with hypertension treated by antihypertensive agents. Method According to the 50th percentile of average real variability（AVR） of 24 hours systolic blood pressure （SBP）,212 elderly men with hyper- tension, who had been treated by Calcium channel blocker over more than 6 months, were divided into two groups ： high AVR group （AVR ≥ 10.17 mmHg） and low AVR group （ AVR 〈 10. 17 mmHg）. 48 elderly age-matched men without hypertension in the same period were selected the control group. Mean blood pressure, systolic blood pressure/diastolic blood pressure AVR values, diastolic interventricular septal thickness （LVST）, left ventricular posterior wall thickness （LVPWT） ,left ventricular end-diastolic diameter （LVEDd） and left ventricular mass index（LVMI） were measured in all the patients. The correlations between blood pressure variability and ventricular remolding were compared. Re- suits Compared with the control group,the AVR and the mean values of SBP in 24 hours, day interval and night in- terval were all higher in elderly men with hypertension （ P 〈 0.05 ）. The IVST and IVEDd were higher in the high AVR group than in the low AVR group （ P 〈 0.05 ）. And the LVMI was positively correlated to the 24 h SBP （ r = 0. 361, P 〈 0.05） and 24h SBP AVR（r = 0. 210,P 〈 0.05 ）. Conclusion The 24 hSBP and 24 hSBP AVR are still correlated to the ventricular remodeling in the elderly men with hypertension treated by antihypertensive agents.