老年高血压患者的动态血压变化

Ambulatory Blood Pressure of Elderly Hypertension Patients

目的探讨老年高血压患者的动态血压变化,为进一步诊断及治疗高血压提供依据。方法选取2014年1∽5月在首都医科大学北京潞河教学医院就诊90例高血压（高血压组）患者和100例血压正常的健康志愿者100例（正常对照组）为研究对象,连续24 h对两组研究对象的血压进行动态监测,观察两组患者血压在白天、夜间以及24 h的变化情况。结果高血压组白天、夜间24 h收缩压均高于正常对照组[（140.2±9.5）mm Hg（1 mm Hg=0.133 k Pa）比（122.5±4.9）mm Hg、（151.6±17.6）mm Hg比（121.7±4.8）mm Hg、（143.1±9.8）mm Hg比（119.8±4.0）mm Hg],（均P〈0.01）;舒张压比较差异无统计学意义（P〉0.05）。高血压组患者的血压存在昼夜波动,夜间收缩压相对较高[（151.6±17.6）mm Hg比（140.2±9.5）mm Hg]（P〈0.01）,但舒张压无明显变化;而正常对照组的收缩压及舒张压均无明显变化。结论高血压患者的收缩压较正常者明显升高,尤其是夜间收缩压,因此要加强对夜间收缩压的控制,并制订出合理的治疗方案,有效防止血压升高所带来的心血管事件。

Objective To study the changes of ambulatory blood pressure among elderly hypertension patients,for further diagnosis and treatment of hypertension.Methods Total of 90 elderly hypertension patients admitted to Luhe Teaching Hospital of Capital Medical University from Jan .2014 to May 2014 were selected as hypertension group and 100 healthy volunteers were selected as control group.The blood pressure was continuously monitored for 24 h, at the changes at day time, night and 24 h of the two groups were observed.Results Compared with control group,the systolic blood pressure of hypertension group was sig-nificantly higher at day-time[（140.2 ±9.5） mmHg vs （122.5 ±4.9） mmHg],night-time[（151.6 ±17.6） mmHg vs （121.7 ±4.8） mmHg] and the 24 h [（143.1 ±9.8） mmHg vs （119.8 ±4.0） mmHg]（P 〈0.01）;diastolic blood pressure had no statistically significant difference（P〉0.05）.The systolic blood pres-sure of hypertension patients showed diurnal fluctuation pressure at night-time [（151.6 ±17.6） mmHg] was higher than day-time[（140.2 ±9.5） mmHg]（P 〈0.01）,but there was no significant difference between diastolic pressure;the diastolic pressure and systolic blood pressure of the control group at day-time and night-time （P〉0.05）.Conclusion Systolic blood pressure of hypertension patients issignificantly higher than nor-mal persons,especially during night-time.So,the control of night-time blood pressure should be enhanced and rational therapeutic schedules should be made to reduce the possibile cardiovascular accidents at night .