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.

24h平均血压、血压昼夜节律与长期药物治疗的高血压患者肾脏损害的相关性研究

目的探讨24 h平均血压、血压昼夜节律对高血压患者肾脏损害的影响。方法分析2017年11月至2019年11月我院就诊的300例长期使用降压药物的高血压患者临床资料,分为24 h平均血压正常昼夜节律正常组(组1)、24 h平均血压正常昼夜节律异常组(组2)、24 h平均血压控制欠佳昼夜节律正常组(组3),24 h平均血压控制欠佳昼夜节律异常组(组4)四组,分析血压昼夜节律与颈动脉斑块情况、脑血管疾病发作情况、心血管疾病发作情况的关系,分析各组患者肌酐、尿素氮、尿蛋白及肌酐清除率变化情况。结果多元Logistic回归分析显示,血压昼夜节律与脑梗死、脑出血、冠心病、动脉粥样硬化、慢性肾衰竭独立相关(P<0.05);肌酐、尿素氮组4与组1各组间比较,差异有统计学意义(P<0.05),其余各组间比较差异无统计学意义;尿蛋白在组2、3与组1比较差异有统计学意义(P<0.05),组2与组3比较差异有统计学意义(P<0.05),组4与组1、2、3各组间比较差异有统计学意义(P<0.05);e GFR组2、3与组1比较差异有统计学意义(P<0.05)。结论长期降压治疗的高血压患者,血压昼夜节律与24 h平均血压共同参与肾脏损害的发生;与24 h平均血压比较,血压昼夜节律异常影响尿蛋白漏出更大,高血压患者不仅要重视血压的达标,更要关注血压昼夜节律的恢复。

原发性高血压患者24h平均脉压与左室肥厚的相关性探讨

目的 探讨原发性高血压患者 2 4h平均脉压与左室肥厚的关系。方法 将 5 8例原发性高血压患者分成两组 -左室肥厚 (LVH)组和非LVH组 ,进行 2 4h无创性动态血压监测。结果 ①两组 2 4h平均脉压 (PP)有显著差异 (P <0 .0 1) ,偶测PP(P <0 .0 5 ) ,LVH组显著高于非LVH组 ;②两组 2 4h平均PP及偶测PP均与左室后壁厚度相对室壁厚度呈正相关。结论 原发性高血压患者脉压增大是导致左室肥厚的相关因素之一 ,2

急性缺血性卒中患者左心室肥厚相关因素的研究

目的:探讨急性缺血性卒中患者左心室肥厚的相关危险因素。方法:选择急性缺血性卒中住院患者681例,对其进行病史采集,体格检查,实验室检查,心脏彩超及动态血压监测,根据有无左心室肥厚分为LVH组(153例)及非LVH组(528例),分析左心室肥厚相关因素。结果:多因素Logistic回归分析提示:尿酸(OR=1.002,95%CI:1.000~1.004,P<0.05),24 h收缩压平均值(OR=1.024,95%CI:1.014~1.034,P<0.01),白昼舒张压变异指数(OR=1.060,95%CI:1.021~1.099,P<0.01)是左心室肥厚的危险因素。BMI(OR=0.919,95%CI:0.870~0.971,P<0.01),夜间收缩压变异指数(OR=0.960,95%CI:0.923~1.000,P<0.05)是左心室肥厚的保护因素。结论:血尿酸,24 h收缩压平均值是急性缺血性卒中患者左心室肥厚的危险因素,有效控制血尿酸及24 h收缩压可降低左心室肥厚的发生。