老年高血压患者诊间血压变异性与靶器官损害的研究

Study on visit-to-visit blood pressure variability and target organ damage in elderly patients with hypertension

目的回顾性分析老年高血压患者诊间血压变异性及对高血压靶器官的影响。方法选取2015年3月至2022年6月南京医科大学第二附属医院收治的225例老年高血压患者为研究对象,根据WHO老年人年龄划分标准,将患者分为两组,年轻老年人组,年龄60~74岁,共121例;高龄老年人组,年龄≥75岁,共104例。分析两组患者的诊间血压变异特点,并比较两组患者靶器官损害相关指标的差异性。结果年轻老年人组患者肾小球滤过率显著高于高龄老年人组,差异有统计学意义(P<0.05);高龄老年人组尿蛋白、合并慢性肾脏病比例显著高于年轻老年人组,差异有统计学意义(P<0.01);高龄老年人组患者平均收缩压、收缩压标准差、收缩压变异系数、平均舒张压、舒张压标准差、舒张压变异系数均显著高于年轻老年人组,差异有统计学意义(P<0.05);肾功能不全组患者组与肾功能正常组患者的血压指标比较,两组mSBP、mDSP差异具有统计学意义(P<0.05)。结论随着年龄增加,诊间血压变异性升高,且血压水平与肾功能有关。

Objective To retrospectively analyze the characteristics of visit-to-visit blood pressure variability in elderly patients with hypertension and its influence on target organs of hypertension.Methods 225 elderly patients with hypertension admitted to the Second Affiliated Hospital of Nanjing Medical University from March 2015 to June 2022 were selected as the research object and divided into two groups according to the WHO age classification standard.The younger elderly group,with 121 patients aged between 60 and 74 years old,the older elderly group,with 104 patients aged over 75 years old.The characteristics of visit-to-visit blood pressure variation between the two groups were analyzed,and the differences of target organ damage related indexes between the two gr oups were com pared.Results The estimated glomerular filtration rate(eG FR)of the younger elderly group was significantly higher than that of the older elderly patients,with statistically significant difference(P<0.05).The proportions of patients with urinary protein and patients with chronic kidney disease(CKD)in the older elderly group were higher than those in the younger e lderly group,with statistically significant differences(P<0.01).The mean systolic blood pressure(mSBP),systolic blood pressure standard deviation(SSD),systolic blood pressure coefficient of variation(SCV),mean diastolic blood pressure(mDBP),diastolic blood pressure standard deviation(DSD)and diastolic blood pressure coefficient of variation(DCV)in the older elderly group were significantly higher than those in the younger elderly group,with statistically significant differences(P<0.05).The comparison of blood pressure indexes between patients with renal insufficiency and patients with normal renal function showed that there were significant differences in mSBP and mDSP between the two groups(P<0.05).Conclusion The visit-to-visit blood pressure variability rises with the increase of age,and the blood pressure level is related to renal function.