老年高血压患者动态血压监测特点及其预测意义

Prognostic Implication of Ambulatory Blood Pressure Monitoring in Elderly Hypertensives

目的 :探讨老年高血压患者动态血压监测特点、正常值及其预测意义。方法 :使用英国产MEDILOGABPmonitoringsystem无创伤性动态血压监测仪对 80例老年高血压患者进行2 4h动态血压监测 ,包括采用固定日间和夜间时间段 ,日间每 15min、夜间每 30min记录 1次。包括 2 4h、日间和夜间收缩压及舒张压 ,2 4h、日间和夜间血压负荷值。结果 :80例患者 2 4h平均压及平均脉压等常用参数值明显高于正常参考值 ,其中白大衣高血压占 15 %。结论 :动态血压监测参数值比随测血压能更准确预测心脑血管并发症状发生。单独诊断白大衣高血压与传统方式有高度一致性。

Objective: To evaluate the features of ambulatory blood pressure monitoring (ABPM) in elderly hypertensives and the prognostic implication. Methods: The noninvasive blood pressure recorder was used to carry out 24 h ABPM in the elderly hypertensives who were not treated at the time of execution of ABP monitoring. Day and night have been arbitrarily defined through fixed time intervals. Blood pressure (BP) readings were obtained automatically at 15 min intervals at daytime and 30 min intervals at nighttime. The parameters analyzed included 24 h systolic blood pressure (SBP), diastolic blood pressure (DBP), mean daytime SBP and DBP, mean nighttime SBP and DBP, blood pressure load and fluctuation of 24 h BP. Results: The values of the above parameters in the elderly hypertensives were significantly higher than in the healthy elderly. Twelve patients were white coat hypertensives. Conclusion: Compared with office BP, mPP and mBP were major independent predictors of cardiac events and cerebrovascular events.