Zhang Qing-qiong, Zhang Xin-jun, Chang Bin-bin, Qiu Bo-yun, Zhang Yan, Li Jun, Zeng Zhi
Department of Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2011 Mar;42(2):252-5.
To investigate the relationship between blood pressure variability (BPV)and target-organ damage in elderly patients with hypertension.
A total of 197 elderly patients were included in the study. The participants were divided into two groups: those with hypertension (n=146) and those without hypertension (Control, n=51). The 24 h systolic and diastolic blood pressure variability (24 h SBPV/DBPV),24 h average systolic and diastolic blood pressure (24 h SBP/DBP), day time systolic and diastolic blood pressure variability (d SBPV/DBPV),and night time systolic and diastolic blood pressure variability (n SBPV/DBPV)were measured. The hypertensive group was further divided into low and high variability groups according to the 50th percentile of 24 h SBPV. The carotid artery intima-media thickness (IMT), left ventricular mass index (LVMI), 24 h microalbuminuria (MA) and basic clinical and laboratory parameters were compared among the groups. The correlations between blood pressure variability and IMT, LVMI, and MA were analyzed with multivariable regression analyses.
The patients with essential hypertension had significantly higher 24 h SBPV (P < 0.001) and d SBPV (P < 0.05) than those without hypertension. The patients with higher blood pressure variability had greater incidence of plaque and cardiovascular disorder, as well as IMT, LVMI and MA (P < 0.001). The prevalence of diabetes mellitus (DM) differed significantly among the three groups of participants (P < 0.05). The multivariable regression analysis showed that 24 h SBPV was independently correlated with IMT, LVMI and MA.
Elderly patients with hypertension have high BPV, which is an important independent predictor of target-organ damage.
探讨老年高血压患者血压变异性（BPV）与靶器官损害之间的关系。
本研究共纳入197例老年患者。参与者被分为两组：高血压患者（n = 146）和非高血压患者（对照组，n = 51）。测量24小时收缩压和舒张压变异性（24小时SBPV/DBPV）、24小时平均收缩压和舒张压（24小时SBP/DBP）、日间收缩压和舒张压变异性（d SBPV/DBPV）以及夜间收缩压和舒张压变异性（n SBPV/DBPV）。高血压组根据24小时SBPV的第50百分位数进一步分为低变异性组和高变异性组。比较各组间的颈动脉内膜中层厚度（IMT）、左心室质量指数（LVMI）、24小时微量白蛋白尿（MA）以及基本临床和实验室参数。采用多变量回归分析血压变异性与IMT、LVMI和MA之间的相关性。
原发性高血压患者的24小时SBPV（P < 0.001）和d SBPV（P < 0.05）显著高于非高血压患者。血压变异性较高的患者斑块和心血管疾病的发生率更高，IMT、LVMI和MA也更高（P < 0.001）。三组参与者中糖尿病（DM）的患病率差异显著（P < 0.05）。多变量回归分析显示，24小时SBPV与IMT、LVMI和MA独立相关。
老年高血压患者BPV较高，这是靶器官损害的重要独立预测因素。
