老年原发性高血压患者血压昼夜节律与尿钠、尿钾排泄的关系

Relationships between circadian rhythm of blood pressure and urinary sodium and urinary potassium excretion in elderly patients with essential hypertension

选取2016年10月至2017年10月重庆市第十三人民医院心内科住院的老年原发性高血压患者59例。根据患者24 h动态血压监测的血压波动情况,分为昼夜节律正常组(杓型组)31例和血压昼夜节律消失组(非杓型组)28例,收集患者24 h尿液并分析24 h尿钠和尿钾水平。非杓型组的24 h收缩压、24 h舒张压、夜间收缩压、夜间舒张压及夜间尿钠排泄量均高于杓型组( P <0.05或 P <0.01),同时非杓型组24 h尿钾低于杓型组( P <0.05)。血压昼夜节律消失的老年原发性高血压患者的尿钠、尿钾排泄呈现明显异常。

Objective:To observe the 24-hour dynamic changes of blood pressure in elderly patients with essential hypertension, and to explore the relationships between abnormal circadian rhythm and urinary sodium and potassium excretion.Methods:From October 2016 to October 2017, 59 elderly patients with essential hypertension were enrolled in the Department of Cardiology, Chongqing Thirteenth People’s Hospital. According to the blood pressure fluctuation monitored by 24-hour ambulatory blood pressure monitoring, the patients were divided into the normal circadian rhythm group(dipper type group, 31 cases) and the disappearance of circadian blood pressure rhythm group(non-dipper type group, 28 cases). 24-hour urine was collected and 24-hour urine sodium and urine potassium levels were analyzed.Results:The 24-hour systolic blood pressure, 24-hour diastolic blood pressure, night systolic blood pressure, night diastolic blood pressure and night urinary sodium excretion in the non-dipper group were higher than those in the dipper group(P<0.05 or P<0.01). The 24-hour urinary potassium in the non-dipper group was lower than that in the dipper group(P<0.05).Conclusion:Urinary sodium and potassium excretion in elderly patients with essential hypertension, whose circadian rhythm of blood pressure disappears, is obviously abnormal.