老年患者24h动态血压监测与高血压临床用药分析

Analysis of 24-hour ambulatory blood pressure monitoring in the assessment of high blood pressure medication in elderly patients

目的评价24h动态血压监测对于高血压患者的疾病诊断价值,并分析高血压临床用药事项。方法对我院在2016年7月至2017年6月1年间收治的236例老年高血压患者的临床资料进行回顾性分析,并且考察不同程度下的24h动态血压监测患者在临床用药方面的差异。结果236例高血压患者中,80.1%患者的收缩压与舒张压同时增高,约90.0%左右的血压负荷值大于40.0%,57.6%的患者血压增高的峰值时间为上下午时均有发生,血压昼夜节律以及分型以非杓形血压居多(58.9%);通过服用降压药物进行治疗以后,血压的各项指标均得到显著改善(P<0.05);常用的降压药物包括血管紧张素受体拮抗剂(ARB)、钙拮抗剂、利尿剂、血管紧张素转换酶抑制剂(ACEI)以及β受体阻滞剂,或上述药物之间组成的联合用药。结论24h动态血压监测可以提供全面的血压测试数据,有效提高高血压的诊断水平,临床中应依据患者的实际病情进行用药治疗。

ObjectiveTo evaluate the value of ambulatory blood pressure monitoring in evaluating hypertension status and the efficacy of antihypertensive medication in hypertension patients. MethodsWe retrospectively collected data from 236 elderly hypertensive patients at our hospital from July 2016 to June 2017 and analyzed the blood pressure characteristics of patients under 24 h ambulatory blood pressure monitoring and the effects of different types of antihypertensive medication. ResultsOf 236 patients with high blood pressure, 80.1% had both higher systolic blood pressure and higher diastolic blood pressure;about 90.0% had blood pressure load greater than 40.0%;blood pressure in 57.6% of patients reached its peak both in the morning and in the afternoon;a majority(58.9%)showed a non-dipper circadian pattern.After antihypertensive drug treatment, the blood pressure indicators significantly improved(P<0.05). Common antihypertensive drugs included calcium antagonists, angiotensin converting enzyme inhibitors(ACEI), angiotensin receptor blockers(ARB), diuretics, beta blockers, and combination drugs. Conclusions24 h ambulatory blood pressure monitoring can provide comprehensive blood pressure data, help achieve accurate assessment of blood pressure status, and may be used in the evaluation of antihypertensive drug treatment.