老年人群高血压发病特点及动态血压监测在疾病管理中的作用

The Characteristics of Hypertension in the Elderly Population and the Role of Dynamic Blood Pressure Monitoring in Disease Management

【目的】探讨动态血压监测在老年高血压患者疾病管理中的作用。【方法】选择2020年10月至2022年9月在本中心就诊的80例老年高血压患者,根据血压节律特点将其分为杓型组(n=12)、非杓型组(n=42)和反杓型组(n=26)。分析老年高血压患者的血压节律、血压均值及血压变异性,分析导致靶器官损害的危险因素。【结果】非杓型组的24 h舒张压变异系数、24 h收缩压变异系数与杓型组比较,差异有统计学意义(P<0.05);反杓型组的夜间收缩压、夜间舒张压、夜间收缩压负荷值、夜间舒张压负荷值与杓型组比较,差异有统计学意义(P<0.05)。非杓型组、反杓型组靶器官损害发生率均高于杓型组(均P<0.05);非杓型组与反杓型组靶器官损害发生率比较,差异无统计学意义(P=0.985)。Logistic多因素回归分析显示,24 h收缩压变异系数和非杓型节律是杓型组及非杓型组靶器官损害的独立危险因素(P<0.05);反杓型血压节律是杓型组及反杓型组靶器官损害的独立危险因素(P<0.05)。【结论】非杓型和反杓型血压节律的老年人更容易发生靶器官损害,动态血压监测是一种有效的监测方法,可用于改善老年高血压患者的血压管理和治疗策略。

【Objective】To explore the role of dynamic blood pressure monitoring in disease management of elderly patients with hypertension.【Methods】Eighty elderly patients with hypertension who visited our center from October 2020 to September 2022 were selected and divided into three groups based on their blood pressure rhythm characteristics:a spoon shaped group(n=12),a non spoon shaped group(n=42),and a reverse spoon shaped group(n=26).We analyzed the blood pressure rhythm,mean blood pressure,and blood pressure variability of elderly hypertensive patients,and analyzed the risk factors leading to target organ damage.【Results】The 24-hour diastolic blood pressure coefficient of variation and 24-hour systolic blood pressure coefficient of variation in the non spoon shaped group were significantly different from those in the spoon shaped group(P<0.05);The nighttime systolic blood pressure,nighttime diastolic blood pressure,nighttime systolic blood pressure load value,and nighttime diastolic blood pressure load value of the anti spoon group were significantly different from those of the spoon group(P<0.05).The incidence of target organ damage in the non spoon shaped group and the anti spoon shaped group was higher than that in the spoon shaped group(both P<0.05);There was no statistically significant difference in the incidence of target organ damage between the non scoop group and the anti scoop group(P=0.985).Logistic multiple regression analysis showed that the 24-hour systolic blood pressure coefficient of variation and non arytenoid rhythm were independent risk factors for target organ damage in both arytenoid and non arytenoid groups(P<0.05);The anti scoop blood pressure rhythm is an independent risk factor for target organ damage in both the scoop and anti scoop groups(P<0.05).【Conclusion】Elderly individuals with non arytenoid and anti arytenoid blood pressure rhythms are more prone to target organ damage,and dynamic blood pressure monitoring is an effective tool for improving blood pressure management and treatment strategies in elderly hypertensive patients.