老老年人群动态血压参数与动脉僵硬度的相关性

摘要

Objective To investigate the relation between ambulatory blood pressure and arterial stiffness in the very elderly. Methods 238 very elderly (age≥80 years) were divided into two groups: 104 normotensive and 134 hypertensive (BP≥160/95 mm Hg, 1 mm Hg=0.133 kPa).Ambulatory blood pressure and brachial-ankle pulse wave velocity(baPWV) were monitored for all subjects. The relationship between parameters of ambulatory blood pressure and arterial stiff-ness was analyzed by Pearson correlation. Results The baPWV of the hypertensive group was significantly higher than that of normotensive group (P < 0.05,P < 0. 01). The casual systolic blood pressure(SBP), 24 h, day(D) and night(N) SBP, diastolic blood pressure(DBP), pulse pres-sure(PP),SBP load and DBP load in hypertensive group were significantly higher than those in the normotensive group. The rates of nocturnal SBP decrease and DBP decrease in the hyperten-sive group were significantly lower than those in the normotensives (P < 0.05, P < 0.01). Pear-son correlation analysis showed that baPWV was positively correlated with casual SBP,casual DBP, 24 h SBP, DBP, PP; day SBP, DBP, PP, HR; night SBP, DBP, PP, SBP load and DBP load,negatively correlated with night SBP decrease (P<0.01). Conclusion Present findings suggest that increase in arterial stiffness is an important factor of hypertension in the very elderly. Arterial stiffness is correlated with ambulatory SBP,DBP,PP, HR and BP load.%目的 探讨老老年人群动态血压参数与动脉僵硬度的相关性.方法 筛选年龄≥80岁的老老年人238例,以血压≥160/95 mm Hg(1 mm Hg=0.133 kPa)为标准,分为高血压组(134例)和对照组(104例),并进行臂-踝脉搏传导速度(baPWV)和24 h动态血压监测.用Pearson分析动态血压各参数与动脉僵硬度的相关性.结果 高血压组baPWV高于对照组(P<0.05).高血压组偶测收缩压,24 h、昼间和夜间收缩压,舒张压、脉压.收缩压负荷及舒张压负荷均高于对照组,夜间收缩压下降率、舒张压下降率低于对照组,差异有统计学意义(P<0.05,P<0.01).baPWV与偶测血压;24 h收缩压、舒张压、脉压;昼间收缩压、舒张压、脉压、心率;夜间收缩压、舒张压、脉压;收缩压负荷、舒张压负荷呈正相关(P<0.05,P<0.01),而与夜间收缩压下降率呈负相关(P<0.01).结论 高血压是老老年人群动脉僵硬度增加的一个重要因素,动脉僵硬度与动态血压、脉压、心率及血压负荷相关.