老年高血压病的不同血压参数变异度与左室肥厚的关系

Relationship between blood pressure variability and left ventricular hypertrophy in elderly with essential hypertension

目的探讨老年高血压患者动态血压各参数变异度及脉压与左室肥厚的关系。方法采用动态血压、超声心动图检查 82例年龄大于 60岁的原发性高血压患者 ,其中 5 1例无左室肥厚 ,31例有左室肥厚 ,对两组动态血压参数进行组间比较及昼夜间比较 ,并对各参数与左室质量指数 ( L VMI)进行相关性分析。结果 1昼、夜收缩压水平、脉压与 LVMI呈强相关 ,左室肥厚组的收缩压、舒张压水平及脉压明显高于无左室肥厚组 ;2两组之间血压变异无差异 ;3所有病例收缩压变异大于舒张压变异 ,收缩压变异白昼大于夜间 ,而昼夜间舒张压变异、脉压水平改变不明显。结论老年高血压患者左室肥厚与血压变异相关性较小 ,主要与收缩压水平与脉压水平相关 ,老年高血压患者 2 4小时舒张压变异与脉压水平处于相对恒定的水平 ,脉压可能是预测老年高血压性左室肥厚的一个简便易行的指标。

Objective To explore the relationship between blood pressure variability(BPV) and pulse pressure(PP) with left ventricular hypertrophy(LVH).Methods Echocardiography and ambulatory blood pressure monitoring(ABPM) were performed in 82 essential hypertension cases who were over 60 years old. They were divided into two groups, including 51 cases without LVH group and 31 cases with LVH group. Blood pressure parameters between the two groups, and between daytime and nighttime in each group were compared. Correlation of each parameter of BPM and left ventricular mass index(LVMI) was analyzed.Results ①There was significant correlation between systolic blood pressure(SBP) and PP and LVMI. In LVH group, SBP, diastolic blood pressure(DBP) and PP were obviously higher than those in non LVH group.② There was no difference in blood pressure variability between the two groups.③Variability of SBP was higher than that of DBP and variability of daytime SBP higher than that of nighttime SBP while the variability in DBP and PP were not obvious between daytime and nighttime in all cases.Conclusion The correlation between LVH and BPV is relatively small in elderly hypertension patients. It is mainly correlated with SBP and PP level. 24 DBP variability and PP are kept relatively stable level, so PP may be used as a convenient index to predict LVH in elderly hypertension patients.