老年高血压患者血压负荷值和血压昼夜节律、靶器官损害相关性

摘要

Objective To investigate the correlation between blood pressure load and circadian rhythm in elderly hypertension patients with target organ damage.Method 150 elderly patients with primary hypertension of Guangdong Reclamation Central Hospital between 60 and 80 years old were included from January 2012 to December 2014.Patients were divided into target organ damage group and simple hypertensive group according to whether or not having target organ damage, with 24-hour ambulatory blood pressure monitoring. Characteristics of blood pressure load and circadian rhythm in two groups, and relevant factors of target organ damage in elderly hypertension patients were analyzed.Results Blood pressure load of target organ damage group was significantly higher than simple hypertension group(52.32±11.89)%, especially at night(63.31 ±13.26)% (P<0.05).The circadian rhythm of target organ damage group was significantly higher than simple hypertension group (P<0.05). Nighttime blood pressure, average systolic blood pressure in 24 hours, blood lipids, carotid artery intima-media thickness, left ventricular mass index, 24-h urinary albumin, and cardiovascular disease were relative with target organ damage in elderly hypertensive patients (P<0.05).Conclusion The elderly hypertensive patients should pay attention to correct disorders of circadian rhythm and pay attention to nighttime blood pressure load in order to minimize damage to the target organ.%目的：探讨老年高血压患者血压负荷值和血压昼夜节律、靶器官损害的相关性。方法连续纳入广东省农垦中心医院2012年1月~2014年12月确诊为原发性高血压的60～80岁老年患者150例，根据是否存在靶器官损害分为靶器官损害组（n=75）和单纯高血压组（n=75），对患者行24 h动态血压监测，并分析两组的血压负荷值和血压昼夜节律特点，分析与老年高血压靶器官损害相关的因素。结果靶器官损伤组的血压负荷值（BPL）尤其是夜间的血压负荷值（63.31±13.26）%显著高于单纯高血压组（52.32±11.89）%，两组差异具有统计学意义（P＜0.05）；靶器官损伤组的昼夜节律显著高于单纯高血压组患者，两组差异具有统计学意义（P＜0.05）；夜间血压、24 h平均收缩压、血脂、颈总动脉内-中膜厚度、左室质量指数、24 h尿微量白蛋白、合并心血管疾病与老年高血压靶器官损害具有相关性（P＜0.05）。结论老年高血压患者应注重纠正紊乱的血压昼夜节律，重视夜间血压负荷值，以最大限度降低对靶器官的损伤。