老年高血压患者心率变异性与动脉硬化的相关性研究

Correlation between heart rate variability and arteriosclerosis in elderly patients with essential hypertension

目的探讨心率变异性与老年高血压患者动脉硬化的相关性。方法选取原发性高血压患者207例,采用肱踝脉搏波传导速度(baPWV)检测作为动脉硬化的评价,根据baPWV结果,将患者分为3组,即正常组S1(baPWV<1400cm/s)、轻度动脉硬化组S2(1400m/s≤baPWV≤2100cm/s)和重度动脉硬化组S3(baPWV>2100cm/s)。检测患者相关生化及血压指标,动态心电监测分析心率变异性(HRV)指标,对脉搏波传导速度和心率变异指标进行相关分析。结果S1、S2、S3三组间年龄、24h平均收缩压(24hSBP)、中心动脉压(CAP)、脉压(PP)及24h正常的R-R间期总体标准差(SDNN)、5min心搏R-R间期平均值的标准差(SDANN)、正常RR间期标准差的平均值(SDNNI)、两个相邻正常R-R间期差值的均方根(RMSSD)、24h内相邻两正常R-R间期差值大于50ms的个数所占的百分数(PNN50)差异有统计学意义(P<0.05),随动脉硬化程度的加重,年龄、24hSBP、CAP、PP逐渐升高,而心率变异指标呈逐渐降低趋势。相关分析显示:老年高血压患者baPWV与心率变异指标SDNN、SDANN、RMSSD呈显著负相关(r=-0.365、-0.216、-0.164,P均<0.05)。结论随年龄增长,老年高血压患者中心动脉压升高,动脉硬化程度加重。老年高血压患者的心率变异性与动脉硬化有显著相关性,心率变异性可作为老年原发性高血压动脉硬化病情及预后判断的一项重要指标。

Objective To investigate the correlation between heart rate variability(HRV)and arteriosclerosis in elderly patients with essential hypertension(EH).Methods A total of 207 elderly hypertensive patients treated were divided into normal group S1(baPWV<1 400 cm/s),mild arteriosclerosis group S2(1 400 m/s≤baPWV≤2 100 cm/s)and severe arteriosclerosis group S3(baPWV>2 100 cm/s)according to brachial-ankle pulse wave velocity(baPWV).The heart rate variability(HRV),blood pressure,and blood biochemical indicators were detected.Correlation among baPWV and HRV indexes were analyzed.Results There were statistically significant differences in age,24 h SBP,CAP,PP,SDNN,SDANN,SDNNI,RMSSD and PNN50 between S1 group,S2 group and S3 group.Age,24h SBP,CAP and PP increased,and the HRV indicators gradually decreased with the degree of arteriosclerosis increased.Pearson correlation analysis indicated that in elderly EH patients,baPWV was significantly inversely correlated with SDNN,SDANN and RMSSD(r=-0.365,-0.216,-0.164.P<0.05).Conclusions CAP and degree of artherosclerosis increase with aging in elderly patients with EH.In elderly EH patients,HRV indexes are significantly correlated with arteriosclerotic extent.HRV can be used as an important indicator for the diagnosis and prognosis of elderly patients with EH.