老年人清晨高血压与脑血管储备功能的相关性

Correlation between morning hypertension and cerebrovascular reserve capacity in the elderly

目的探讨老年人清晨血压与脑血管储备功能(CVR)的关系。方法选择2020年5月至2021年6月山东济南地区老年人505例进行24 h动态血压监测,根据监测结果分为清晨高血压组287例、清晨血压正常的高血压降压组(清晨血压降压组)111例和非清晨高血压组107例。评估所有受试者的CVR、屏气指数(BHI)以及搏动指数(PI)。结果清晨高血压组CVR、BHI最低,PI最高(P<0.05)。与非清晨高血压组比较,清晨血压降压组CVR明显降低(P<0.05)。清晨收缩压及舒张压与CVR(r=-0.484、r=-0.254,P=0.000)、BHI(r=-0.482、r=-0.336,P=0.000)呈明显负相关,与PI呈明显正相关(r=0.488、r=0.291,P=0.000)。多元线性回归分析显示,清晨收缩压及舒张压是CVR、BHI和PI的独立危险因素(P校正<0.01)。logistic回归分析显示,清晨高血压患者发生CVR受损的风险明显增高(95%CI:1.098~4.163,P校正<0.05)。结论清晨高血压可增加老年人CVR损伤的风险,是CVR损伤的独立危险因素。

Objective To investigate the relationship between morning hypertension and cerebrovascular reserve(CVR)in the elderly.Methods From May 2020 to June 2021,505 participants aged 60 years and older were eligible and recruited from Jinan,Shandong.24-hour ambulatory blood pressure monitoring was performed on all of them,and subsequently,they were divided into morning hypertension group(n=287),hypertension with antihypertensive treatment but normal morning blood pressure group(n=111),and non-morning hypertension group(n=107).CVR,BHI and PI were evaluated using transcranial Doppler ultrasound.Results Compared with the non-morning hypertension group and the hypertension with antihypertensive treatment but normal morning blood pressure group,CVR and BHI were significantly lower and PI was higher in the morning hypertension group(P<0.05).Compared with the non-morning hypertension group,CVR was significantly lower in the hypertension with antihypertensive treatment but normal morning blood pressure group(P<0.05).Morning systolic and diastolic blood pressures were negatively correlated with CVR(r=-0.484,-0.254;P=0.000)and BHI(r=-0.482,-0.336;P=0.000)while positively with PI(r=0.488,0.291;P=0.000).The results of multiple linear regression analysis showed that morning systolic and diastolic blood pressures were independent influencing factors of CVR,BHI,and PI after adujstment for confunders(adjusted P<0.001).Logistic regression analysis showed that the risk of CVR impairment in the morning hypertension group was significantly higher after adujstment for confunders(95%CI:1.098-4.163,adjusted P<0.05).Conclusion Morning hypertension increases the risk of CVR impairment in the elderly,and is an independent risk factor of CVR impairment.