高龄高血压患者血压达标情况及影响因素分析

Analysis of blood pressure level and its influencing factors in elderly patients with hypertension

目的 探讨高龄高血压患者的血压达标情况及影响因素。方法 选取2015年4月~9月于华北理工大学附属医院老年病科住院的高龄高血压患者111例，其中男性45例，女性66例，年龄80~96岁。将血压水平维持在150/90 mmHg（1 mmHg=0.133kPa）以下分为达标组（60例），血压水平超过150/90mmHg分为未达标组（51例）。收集两组一般资料（年龄、性别、体育锻炼程度、规律用药等），血脂和空腹血糖、血尿酸数据。测定微型营养评分（MNA-SF）、匹兹堡睡眠质量评分（PSQI）及汉密尔顿焦虑量评分（HAMA焦虑评分）。结果 与达标组比较，未达标组年龄、尿酸水平、PSQI评分增加，男性比、规律用药比例、体育锻炼积极比例下降，差异有统计学意义（P均＜0.05）。回归分析结果显示女性（OR=4.854，95%CI：1.324~17.875）为高龄高血压患者血压不达标的危险因素，规律用药（OR=0.044，95%CI：0.012~0.166）、低血尿酸水平（OR=0.983，95%CI：0.971~0.994）及睡眠质量好（OR=0.745，95%CI：0.599~0.926）为高龄高血压患者血压未达标的保护因素。结论 规律用药、低血尿酸水平及睡眠质量好的高龄高血压患者血压达标率高，女性高龄高血压患者血压未达标率高。

Objective To study the blood pressure level and its influencing factors in elderly patients withhypertension. Methods 111 elderly patients with hypertension hospitalized in department of geriatrics of the AffiliatedHospital of North China University of Science and Technology from April to September 2015 were included (45 males,66 females, age 80~96). According to blood pressure, patients were divided into the controlled group (less than or equalto 150/90mmHg) and the uncontrolled group (over 150/90mmHg). Data including general information (age, sex, levelof physical activity, regularity of drug taking and so on), lipids fat, fasting glucose and uric acid were collected. Shortformof Mini-nutritional Assessment (MNA-SF), Pittsburg Sleep Quality Index (PSQI) and Hamilton Anxiety RatingScale (HAM-A) were used to test patients. Results Compared with the controlled group, age, percentage of males, uricacid level and PSQI score were increased, the proportion of regular medication and the proportion of active physicalexercise were decreased, the difference was statistically significant (P<0.05). The results of regression analysis showedthat female (OR=4.854,95%CI:1.324~17.875) is the risk factor of uncontrolled hypertension in elderly patients,regular medication (OR=0.044,95%CI:0.012~0.166), low blood uric acid (OR=0.983,95%CI:0.971~0.994) andgood quality sleep (OR=0.745,95%CI:0.599~0.926) were the protective factors. Conclusion Elderly hypertensivepatients with regular medication, lower blood uric acid level and good quality sleep may have higher rate of controlledblood pressure, female elderly hypertensive patients may have higher rate of uncontrolled blood pressure.