目的 分析中国河南信阳农村地区老年女性高血压患者的临床特征.方法 回顾性分析2004年10月～2005年3月收集的河南信阳农村地区的临床病历资料完整的女性高血压患者2847例.将年龄≥60岁的1166例作为老年组,年龄45～59岁的1681例作为中年组,比较2组患者临床特征、诊室血压及不同体位血压等差异.结果 老年组基线收缩压水平显著高于中年组,舒张压低于中年组(P＜0.0l).与中年组比较,老年组3级高血压、腹型肥胖、高TC血症及高尿酸血症比例更高,且更易伴发冠心病、脑卒中、肾功能不全等临床合并症(P＜0.01),发生体位性低血压的比例更高(18.2％ vs 15.2％,P=0.033).老年组与中年组患者未接受降压治疗比例均为59.3％.多因素回归分析校正年龄等危险因素后显示,体位性低血压与老年女性高血压患者冠心病风险呈正相关(OR=1.632,95％CI:1.200～2.218,P=0.002),与脑卒中无关.结论 老年高血压女性较中年高血压女性合并更多的危险因素和临床合并症,容易发生体位性低血压.%Objective To analyze the clinical characteristics of elderly female hypertension patients in Xinyang rural areas of Henan Province,China.Methods The clinical data of 2847 elderly female hypertension patients aged 45-75 years in Xinyang rural areas of Henan Province,China from October 2004 to March 2005 were retrospectively analyzed.The patients were divided into ≥ 60 years old group (n =1166) and 45-59 years old group (n =1681).Their clinical complications,laboratory testing data,blood pressure were compared.Results The baseline SBP was significantly higher while the baseline DBP was significantly lower in ＞60 years old group than in 45-59 years old group (P＜0.01).The incidence of grade 3 hypertension,abdominal obesity,hyperlipidemia,hyperuricemia,coronary artery disease,ischemic stroke,renal dysfunction,postural hypotension was significantly higher in ≥60 years old group than in 45-59 years old group (P＜0.05,P＜0.01).The rate of patients in two groups who did not receive antihypertension therapy was similar (59.3 ％).Multivariate regression analysis showed that postural hypotension was positively associated with coronary heart disease and negatively associated with ischemic stroke in elderly female hypertension patients after adjustment of conventional risk factors (OR=1.632,95％CI:1.200-2.218,P=0.002).Conclusion The risk of postural hypotension is hiher in elderly female hypertension patients than in middle-aged female hypertension patients.Postural hypotension is positively associated with coronary artery disease in elderly females.
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