老老年高血压患者静息心率与动态血压水平相关性研究

The correlation between resting heart rate and blood pressure levels of hypertension ambulatory in very elderly patients

目的 研究老老年高血压患者静息心率与动态血压参数之间的相关性.方法 选取2013年2月至2014年2月中国中医科学院广安门医院心内科老老年高血压住院患者147例,均行动态血压监测及心电图检查.根据静息心率的数值将患者分成4组：RHR≥80次/min为1组,70次/min≤RHR≤79次/min为2组,60次/min≤RHR≤69次/min为3组,50次/min≤RHR≤59次/min为4组.比较四组之间的一般临床资料、常规生化指标和动态血压参数.结果 各组比较：总胆固醇3组＞1组,P＜0.05;低密度脂蛋白1组＞其余三组;24h平均DBP 1组（67.11±8.55）mm Hg＞3组（61.47±8.34）mm Hg,1组＞4组（61.79±7.77）mm Hg;白天平均DBP 1组（67.29±8.95）mm Hg＞3组（62.22±8.48）mm Hg,1组＞4组（61.53±8.44）mm Hg;白天SBP负荷1组（40.61±32.57）mm Hg＞2组（33.16±33.36）mm Hg＞3组（23.00±26.26）mm Hg＞4组（20.87±27.22）mm Hg,差异均有统计学意义（P＜0.05）.经多元线性逐步回归分析显示,24h平均DBP、LDL-C为静息心率的影响因素.结论 老老年高血压患者的静息心率与全天平均DBP、LDL-C有着密切的联系,故在诊疗中应予以重视,以期进一步改善生活质量及心脑血管病预后.

Objective To study the correlation between resting heart rate of the very elderly patients with hypertension and ambulatory blood pressure parameters.Methods 147 very eldedy patients of Cardiovascular departmentof Guanganmen Hospital attached to China Academy of chinese medical sciences from 2013 February to 2014 February were choosen.Every patient was given ambulatory monitoring of blood pressure and electrocardiogram examination,patients were divided into four groups according to the resting heart rate （RHR） of them,RHR≥80 beats/min was groups 1,70 beats/min ≤ RHR ≤ 79 beats/min was group 2,60 beats/min≤RHR≤69beats/min was group 3,50 beats/min ≤ RHR ≤ 59 beats/min was group 4.The biochemical indexes and parameters of ambulatory blood pressure or clinical data of the four groups were analyzed.Results The results comparison of the groups：total cholesterol was higher in 3 group〉group 1 （P〈0.05）; low density lipoprotein：group 1〉other 3 groups,average 24 h DBP：group 1 （67.11±8.55）mm Hg〉 group 3 （61.47±8.34）mm Hg,group 1 （67.11±8.55）mm Hg〉 group 4 （61.79±7.77）mm Hg,the average daytime DBP：group 1 （67.29±8.95）mm Hg〉group 3（62.22±8.48）mm Hg,group 1（67.29±8.95）mm Hg〉 group 4（61.53±8.44）mm Hg,the SBP load：group 1 （40.61±32.57）mm Hg〉group 2（33.16±33.36）mm Hg〉 group 3（23.00±26.26）mm Hg〉group 4（20.87±27.22）mm Hg （P〈0.05）,the difference was statistically significant.Multiple linear stepwise regression analysis showed that the average DBP of 24 h,LDL-C were effective factors of resting heart rate.Conclusion Resting heart rate and average day DBP,LDL-C were closely correlation in very elderly hypertensive patients,so it should be paid more attention to RHR in the diagnosis and clinical treatment,in order to further improve the quality of life and heart cerebrovascular disease prognosis of very elderly patients hypertension.