季节气象因素对高龄老年原发性高血压病患者血压波动的影响

Influence of seasonal meteorological factors on blood pressure fluctuation in elderly patients with essential hypertension

目的分析不同季节气温变化对高龄老年原发性高血压病患者血压波动的影响。方法纳入高龄老年原发性高血压病的住院患者。收集患者一般资料、24 h动态血压数据、血浆同型半胱氨酸(Hcy)水平和佩戴动态血压计当日的气象资料,比较不同性别、不同季节血压值及血压波动情况,分别探讨气温和Hcy对原发性高血压患者血压的影响。结果男性的24 h平均收缩压(24 hSBP)、24 h收缩压标准差(24 hSSD)、24 h脉压指数(24 hPPI)均高于女性,男性的脑卒中病史比例高于女性。季节分组结果显示,24 hSBP表现为冬季最高,春秋次之,夏季最低;冬季24 hSSD、24 hPPI高于其他季节。低温组中,H型高血压组24 hSSD较高,24 hSSD与Hcy呈正相关。春、夏、秋3个季节日平均气温与24 hSBP呈线性负相关。日平均气温每升高1℃,24 hSBP降低0.641 mmHg。结论高龄老年原发性高血压病患者血压存在季节性波动,其中H型高血压病患者对寒冷更敏感。

Objective To analyze the influence of temperature changes in different seasons on blood pressure fluctuation in very old patients with essential hypertension.Methods Elderly inpatients with essential hypertension were included in this study.The general data of 24-hour ambulatory blood pressure,plasma homocysteine(Hcy)level and meteorological data of the day obtained by wearing ambulatory sphygmomanometer were collected.Blood pressure values and fluctuations of blood pressure in different sexes and different seasons were compared.Effects of temperature and Hcy on blood pressure in essential hypertensive patients were discussed.Results The 24 h mean systolic blood pressure(24 hSBP),the 24 h standard deviation of systolic blood pressure(24 hSSD)and the 24 h pulse pressure index(24 hPPI)were higher in males than those of females,and the proportion of stroke history was higher in males than that in females.The results of seasonal grouping showed that 24 hSBP was the highest in winter,followed by spring and autumn,and the lowest in summer.The 24 hSSD and 24 hPPI were higher in winter than those in other seasons.In the hypothermia group,24 hSSD was higher in the type H hypertension group,and it was positively correlated with Hcy.The daily average temperature in spring,summer and autumn was negatively correlated with 24 hSBP.The 24 hSBP decreased by 0.641 mmHg when the daily mean temperature increased by 1℃.Conclusion The blood pressure of very old patients with essential hypertension fluctuates seasonally.Patients with H hypertension are more sensitive to cold.