老年高血压患者诊室血压和动态血压达标情况分析

The rates of controlled office blood pressure and ambulatory blood pressure in elderly hypertensive patients

目的探讨老年高血压患者诊室血压和动态血压达标情况及影响因素。方法在参加2010-2011年度健康体检的开滦离退休员工中整群抽取年龄≥60岁的2814人进行动态血压监测,符合入选标准者2464人,分析其中754例服用抗高血压药物的老年高血压患者诊室血压达标（诊室血压〈140/90mm Hg）和24h动态血压达标（24h平均血压〈130/80mm Hg）情况。采用Logistic回归分析影响老年高血压患者动态血压不达标的相关因素。结果老年高血压患者754例中,诊室血压达标率19.2%（95%CI16.4%~22.0%）,24h动态血压达标率33.6%（95%CI30.2%~37.0%）。诊室血压达标的145例老年高血压患者中,24h动态血压达标率为51.0%（95%CI42.9%~59.1%）,男性、体质量指数（BMI）是24h动态血压不达标的危险因素,OR值（95%CI）分别为2.942（1.155~7.498）,1.195（1.031~1.386）。诊室血压不达标的609例老年高血压患者中,24h动态血压达标率为29.4%（95%CI25.8%~33.0%）,男性、诊室收缩压、BMI是24h动态血压不达标的危险因素,OR值（95%CI）分别为1.679（1.125~2.506）,1.030（1.019~1.042）,1.067（1.007~1.130）。结论老年高血压患者诊室血压和动态血压达标率低,男性、BMI、诊室收缩压是影响24h动态血压不达标的危险因素。

Objective To investigate controlled rates and influencing factors of ambulatory blood pressure（ABP）and office blood pressure（OBP）in elderly hypertensive patients. Methods A total of 2814 participants who underwent a physical examination between 2010 and 2011were selected with cluster sampling from retired employees aged over 60 years in Kailuan Group Company,and 2464 employees met the enrolling criteria. Finally,the control rates of ABP and OBP were analyzed in 754 hypertensive patients having taken medication. Logistic regression analysis was used to analyze the related risk factors of uncontrolled ABP（24 h mean blood pressure≥130/80 mm Hg）. Results In 754 elderly hypertensive patients,control rats of OBP and ABP were 19.2%（95% CI16.4%-22.0%）and 33.6%（95% CI 30.2%-37.0%）. In 154 patients with OBP controlled,the rate of ABP controlled was 51.0%（95% CI42.9%-59.1%）. Male and BMI were risk factors for uncontrolled ABP with an ORvalues（95% CI）of 2.942（1.155-7.498）and 1.195（1.031-1.386）respectively. In 609 patients with uncontrolled OBP,control rate of ABP was 29.4%（95% CI25.8%-33.0%）,and male,office systolic blood pressure and BMI were risk factors for uncontrolled ABP with an ORvalues（95% CI）of 1.679（1.125-2.506）,1.030（1.019-1.042）and 1.067（1.007-1.130）respectively. Conclusion The controlled rates of OBP and ABP in elderly patients with hypertension were low. Male,office systolic blood pressure and BMI were risk factors for uncontrolled ABP.