晨峰血压增高对老年高血压患者心脑血管危险因素的影响

摘要

Objective To investigate the effect of increased morning blood pressure surge (MBPS) on the risk factors of cardio-cerebrovascular diseases in elderly hypertensive patients. Methods 24-hour ambulatory blood pres-sure monitor was used in 156 elderly patients with primary hypertension. According to the results of ambulatory blood pressure, the patients were divided into increased MBPS group (n=92) and non-increased MBPS (n=64). Meanwhile, brain magnetic resonance imaging (MRI), carotid ultrasonography, color echocardiography, myocardial perfusion imag-ing (MPI), and biochemical indexes were determined in these patients. Results Compared with non-increased MBPS group, patients in MBPS group had older age, and higher fasting blood glucose (FBG) and CRP. Also, multiple cere-bral infarction, thicker carotid intima, larger left ventricular mass index, severe myocardial ischemia and microalbu-minuria were more common in MBPS group, with a statistically significant difference. Conclusion Higher MBPS in-creases the risks of cardiovascular diseases in elderly hypertensive patients. Therefore it should be identified early and warrant aggressive prevention.%目的：探讨晨峰血压增高（MS）对老年高血压患者心脑血管危险因素的影响。方法应用24 h动态血压仪监测156例老年原发高血压患者，根据动态血压结果分为MS组（92例）和非MS组（64例），同时完善头磁共振成像、颈动脉彩色多普勒超声、心脏彩色多普勒超声、心肌核素灌注显像及生化指标。结果与非MS组相比较，MS组患者年龄更大，空腹血糖及C反应蛋白更高，存在更多的多发脑梗死，颈动脉内膜更厚，左心室质量指数更大，心肌缺血及尿微量白蛋白更严重，差异均有统计学意义。结论 MS增加了老年高血压患者心脑血管事件的风险，应注意早期识别，积极预防。