Blood Pressure Variability and Its Relationship with Cognitive Function in Elderly Patients with Essential Hypertension and Type 2 Diabetes

Objective: To investigate blood pressure variability of Elder hypertensives with type 2 diabetes and its relationship with cognition. Methods: A total of 143 elderly hypertensives were enrolled and divided into diabetic group (59 cases) and non-diabetic group (84 cases). The difference of general clinical characteristics, biochemical parameters, carotid ultrasound, a neuropsychological Scales and 24-hour ambulatory blood pressure (24hABPM) parameters between the two groups of subjects were compared. Then, the two groups (diabetic group and non-diabetic group) were further divided into (Mild cognitive dysfunction) subgroup (MMSE>26) and normal cognition subgroup (MMSE≤26), respectively. On the basis of MMSE scores, the difference of the parameters of ABPM between the two subgroups was analyzed. Results: Compared with the control group, 24hSBP, 24hPP, dSBP, dPP, nSBP, nPP, 24hSSD, dSSD, nSSD, 24hSCV, dSCV and nSCV were significantly higher in the diabetic group (p<0.05). However, cognition was lower in the diabetic group. No significant difference was found in the circadian pattern of blood pressure between the two groups. 24hSSD, dSSD, nSSD, 24hSCV, dSCV, nSCV were significantly higher in the MCI subgroup than normal cognition subgroup in both diabetic and non-diabetic groups(p<0.05), and they were negatively associated with scores of MMSE, the correlation coefficient were -0.235,-0.246,-0.341,-0.158,-0.222,-0.238 (0.001≤P<0.05). Conclusion: The study showed that in the elderly with hypertension, the mean systolic blood pressure and blood pressure variability were both higher in the diabetic group, and the cognition was lower instead. Whether or not with diabetes, blood pressure variability was always higher in the MCI subgroup. Blood pressure variability increased in patients with diabetes, and was associated with cognitive decline.

孕期子痫前期中24 h动态血压监测的应用及孕期血压节律性变化规律研究

目的:探讨孕期子痫前期中24 h动态血压监测的应用及孕期血压节律性变化的规律。方法:选取2016年4月-2019年4月50例孕期子痫前期患者作为观察组,另选择同时间60例孕期正常者为对照组。两组患者均进行24 h动态血压监测,比较两组血压相关指标、肾功能、不同严重程度子痫患者24 h血压及围产儿结局。结果:观察组24 h SBP、24 h DBP、dSBP、dDBP、nSBP、nDBP均高于对照组,差异均有统计学意义(P<0.05)。观察组BUN、Scr、SUA均高于对照组,差异均有统计学意义(P<0.05)。轻度子痫前期者24 h平均血压、日间平均血压及夜间平均血压均低于重度子痫前期者,差异均有统计学意义(P<0.05)。观察组母婴不良妊娠结局发生率高于对照组,差异有统计学意义(P<0.05)。结论:通过对孕期子痫前期患者进行24 h动态血压监测,可充分了解患者血压变化,及时采取干预措施并利用24 h动态血压监测了解其治疗的效果,为合理安排治疗及护理操作提供依据,从而降低子痫的发生,确保母婴安全,值得推广应用。

西地那非联合比索洛尔治疗顽固性高血压的疗效分析

目的研究西地那非联合比索洛尔治疗顽固性高血压的临床疗效。方法选择2016年1月—2019年1月四川省甘孜藏族自治州卫生学校附属医院治疗的150例顽固性高血压患者作为研究对象,采用抽签法将患者随机分为对照组和观察组,每组各75例。对照组口服富马酸比索洛尔片,5 mg/次,1次/d。观察组在对照组的基础上口服枸橼酸西地那非片,50 mg/次,1次/d。两组均连续服药8周。观察两组患者的血压和症状疗效,同时比较两组治疗前后的24 h动态血压。结果治疗后,观察组的血压控制总有效率为85.33%,明显高于对照组的65.33/%(P<0.05)。治疗后,观察组的症状改善总有效率为94.67%,明显高于对照组的72.00%(P<0.05)。治疗后,两组患者日间舒张压(d DBP)、日间收缩压(d SBP)、24 h舒张压(24 h DBP)、24 h收缩压(24 h SBP)、夜间舒张压(n DBP)和夜间收缩压(n SBP)均显著降低(P<0.05);且观察组的24 h动态血压水平明显低于对照组(P<0.05)。结论西地那非联合比索洛尔对顽固性高血压患者具有较好的疗效,值得应用推广。