In patients with primary hypertension,therapeutic strategies should be based on global cardiovascular risk profile rather than on the severity of blood pressure alone.Accurate assessment of concomitant risk factors an...In patients with primary hypertension,therapeutic strategies should be based on global cardiovascular risk profile rather than on the severity of blood pressure alone.Accurate assessment of concomitant risk factors and especially of the presence and extent of subclinical organ damage is of paramount importance in definingindividual risk.Given the high prevalence of hypertension in the population at large,however,extensive diagnostic evaluation is often impractical or unfeasible in clinical practice.Low cost,easy to use markers of risk are needed to improve the clinical management of patients with hypertension.Early renal abnormalities such as a slight reduction in glomerular filtration rate and/or the presence of microalbuminuria are well known and powerful predictors of cardio-renal morbidity and mortality and provide a useful,low cost tools to optimize cardiovascular risk assessment.A greater use of these tests should therefore be implemented in clinical practice in order to optimize the management of hypertensive patients.展开更多
目的了解老年原发性高血压(EH)住院患者慢性肾病(CKD)检出率,分析相关影响因素。方法选择确诊的977例EH患者,分为老年EH组575例和非老年EH组402例,同期选择健康体检者4610例为老年对照组,回顾分析CKD的影响因素。结果老年EH组尿蛋白和...目的了解老年原发性高血压(EH)住院患者慢性肾病(CKD)检出率,分析相关影响因素。方法选择确诊的977例EH患者,分为老年EH组575例和非老年EH组402例,同期选择健康体检者4610例为老年对照组,回顾分析CKD的影响因素。结果老年EH组尿蛋白和估算肾小球滤过率(eGFR)下降比例高于非老年EH组(28.5%vs 11.4%、18.3%vs 4.5%,P<0.05);老年EH组CKD检出率高于非老年EH组和老年对照组(33.7%vs12.4%和3.9%,P<0.05,P<0.01);收缩压每升高20 mm Hg(1 mm Hg=0.133kPa),CKD检出率明显增加(P<0.05)。老年EH组合并CKD的危险因素为糖尿病、年龄、血尿酸、收缩压水平(OR=1.702、1.056、1.013、1.007,P<0.01)。结论住院老年EH患者CKD检出率高于非老年,其发病与血糖、血尿酸及血压水平有关。展开更多
目的探讨老年人群中血压变异性与肾功能损害之间的关系。方法纳入123例老年高血压患者,计算入组患者的肾小球滤过率(GFR),以90 m L/min为临界值将其分为肾功能正常组和肾功能异常组,监测患者的24 h动态血压。结果 (1)肾功能正常组白天...目的探讨老年人群中血压变异性与肾功能损害之间的关系。方法纳入123例老年高血压患者,计算入组患者的肾小球滤过率(GFR),以90 m L/min为临界值将其分为肾功能正常组和肾功能异常组,监测患者的24 h动态血压。结果 (1)肾功能正常组白天的收缩压变异性明显小于肾功能异常组,但是白天的平均血压肾功能正常组却显著高于肾功能异常组;(2)年龄、白天收缩压的变异性与GFR呈负相关,而全天的舒张压,白天的舒张压、平均血压,夜间的舒张压与GFR呈正相关。结论血压变异性尤其是收缩压的变异性与肾功能不全独立相关。展开更多
文摘In patients with primary hypertension,therapeutic strategies should be based on global cardiovascular risk profile rather than on the severity of blood pressure alone.Accurate assessment of concomitant risk factors and especially of the presence and extent of subclinical organ damage is of paramount importance in definingindividual risk.Given the high prevalence of hypertension in the population at large,however,extensive diagnostic evaluation is often impractical or unfeasible in clinical practice.Low cost,easy to use markers of risk are needed to improve the clinical management of patients with hypertension.Early renal abnormalities such as a slight reduction in glomerular filtration rate and/or the presence of microalbuminuria are well known and powerful predictors of cardio-renal morbidity and mortality and provide a useful,low cost tools to optimize cardiovascular risk assessment.A greater use of these tests should therefore be implemented in clinical practice in order to optimize the management of hypertensive patients.
文摘目的了解老年原发性高血压(EH)住院患者慢性肾病(CKD)检出率,分析相关影响因素。方法选择确诊的977例EH患者,分为老年EH组575例和非老年EH组402例,同期选择健康体检者4610例为老年对照组,回顾分析CKD的影响因素。结果老年EH组尿蛋白和估算肾小球滤过率(eGFR)下降比例高于非老年EH组(28.5%vs 11.4%、18.3%vs 4.5%,P<0.05);老年EH组CKD检出率高于非老年EH组和老年对照组(33.7%vs12.4%和3.9%,P<0.05,P<0.01);收缩压每升高20 mm Hg(1 mm Hg=0.133kPa),CKD检出率明显增加(P<0.05)。老年EH组合并CKD的危险因素为糖尿病、年龄、血尿酸、收缩压水平(OR=1.702、1.056、1.013、1.007,P<0.01)。结论住院老年EH患者CKD检出率高于非老年,其发病与血糖、血尿酸及血压水平有关。
文摘目的探讨老年人群中血压变异性与肾功能损害之间的关系。方法纳入123例老年高血压患者,计算入组患者的肾小球滤过率(GFR),以90 m L/min为临界值将其分为肾功能正常组和肾功能异常组,监测患者的24 h动态血压。结果 (1)肾功能正常组白天的收缩压变异性明显小于肾功能异常组,但是白天的平均血压肾功能正常组却显著高于肾功能异常组;(2)年龄、白天收缩压的变异性与GFR呈负相关,而全天的舒张压,白天的舒张压、平均血压,夜间的舒张压与GFR呈正相关。结论血压变异性尤其是收缩压的变异性与肾功能不全独立相关。
