增龄及性别与老年高血压患者血压昼夜节律特征的关系

The relationship aging,gender and the characteristic of diurnal rhythm of blood pressre in the elderly patients with hypertension

目的探讨增龄、性别对老年高血压患者血压昼夜节律的影响。方法选择2014年7月至2015年6月在该院老年病科住院的346例老年高血压患者作为研究对象,按年龄段分为老年1组(60~<70岁)77例、老年2组(70~<80岁)109例和老年3组(≥80岁)160例,对比分析三组患者24小时动态血压监测(24h ABPM)参数及动态血压昼夜节律异常发生率。结果老年3组和老年2组24小时平均舒张压(24h DBP)均低于老年1组,差异均有统计学意义(P<0.05)。三组患者血压昼夜节律异常率分别为76.63%、87.16%和90.63%。老年3组血压昼夜节律异常率显著高于老年1组,差异有统计学意义(P<0.05)。男女两组患者的24h ABPM参数比较,差异无统计学意义(P>0.05)。结论老年高血压患者多数血压昼夜节律消失,并且血压昼夜节律特征多为非杓型和反杓型血压。增龄是血压昼夜节律消失的一个重要因素,老年高血压患者血压昼夜节律特征与性别无关。

Objective To investigate the relationship between aging,gender and the blood pressure diurnal rhythm in the elderly patients with hypertension. Methods A total of 346 cases of elderly patients with hypertension in the hospital were collected and divided into three groups according to age ：group 1（age 60-70）（n=77）,group 2（age 70-80）（n=109）,Group 3（age≥80）（n=160）. The blood pressure parameters of the 24 hours average diastolic pressure（24h ABPM） and the abnormal rate of circadian rhythm were compared and analyzed in the three groups. Results 24 h DBP was lower in the group 3 and group2 than in group 1,the difference was statistically significant（P〈0.05）. The rate of abnormal of diurnal rhythm of blood pressre was 76.63%（group 1）,87.16%（group 2） and 90.63%（group 3） respectively,and it was remarkable difference between group 1and group 3,the difference was statistically significant（P〈0.05）. There was no significant difference between male and female in the parameters of diurnal rhythm of blood pressre（P〉0.05）. Conclusion The diurnal rhythm of blood pressre is disappeared with in elderly patients with hypertension. Non-dipper and reverse dipper blood pressure is more commonly existed with the char acteristic of diurnal rhythm of blood pressre in the elderly patients with hypertension. The age increases is an important fac toron of disappeared with the diurnal rhythm of blood pressre. There is independence between gender and the characteristic of diurnal rhythm of blood pressre in the elderly patients with hypertension.