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年龄对老年高血压治疗患者左心室几何形态和舒张功能的影响。

Impact of age on left ventricular geometry and diastolic function in elderly patients with treated hypertension.

作者信息

Toba Ayumi, Kariya Taro, Aoyama Rie, Ishiyama Taizo, Tsuboko Yusuke, Takeda Kazuhiro, Fujimoto Hajime, Shimokado Kentaro, Harada Kazumasa

机构信息

a Division of Cardiology , Tokyo Metropolitan Geriatric Hospital , Tokyo , Japan.

b Division of Geriatrics and Vascular Medicine , Tokyo Medical and Dental University Hospital , Tokyo , Japan.

出版信息

Blood Press. 2017 Oct;26(5):264-271. doi: 10.1080/08037051.2017.1306422. Epub 2017 Mar 22.

Abstract

PURPOSE

Left ventricular (LV) remodelling is observed in numerous patients with hypertension and is a principal cause of heart failure in elderly patients. The aim of this study was to determine the relationships between age and structural/functional LV remodelling observed in elderly hypertensive patients.

METHODS

A total of 557 elderly hypertensive patients (mean age: 74.0 ± 8.6 years) with preserved LV systolic function underwent echocardiography and 24-hour blood pressure (BP) measurement.

RESULTS

Overall, 41.1% of patients had LV hypertrophy, 77.9% had increased relative wall thickness (RWT) defined as RWT >0.42, and 31.8% had both. Logistic analysis of the entire study population showed that increased RWT was associated with both 24-hour systolic BP (odds ratio (OR) 1.38, 95% confidence interval (CI) 1.12 to 1.70) and age (OR 1.32, 95%CI 1.08 to 1.61), whereas increased RWT was associated only with age (OR 1.61, 95%CI 1.23 to 2.11) after excluding patients with LV hypertrophy. Univariate and multivariate linear regression analyses of all patients showed that LV diastolic echocardiographic parameters were consistently associated with age (p ≤ .001) alone, even considering LV structural changes.

CONCLUSIONS

Age was independently correlated with LV concentric/functional changes regardless of LV hypertrophy, suggesting that ageing is independently involved in the progression of LV remodelling.

摘要

目的

众多高血压患者存在左心室(LV)重构,这是老年患者心力衰竭的主要原因。本研究旨在确定老年高血压患者年龄与观察到的左心室结构/功能重构之间的关系。

方法

总共557例左心室收缩功能保留的老年高血压患者(平均年龄:74.0±8.6岁)接受了超声心动图检查和24小时血压(BP)测量。

结果

总体而言,41.1%的患者有左心室肥厚,77.9%的患者相对室壁厚度(RWT)增加(定义为RWT>0.42),31.8%的患者两者都有。对整个研究人群的逻辑分析表明,RWT增加与24小时收缩压(优势比(OR)1.38,95%置信区间(CI)1.12至1.70)和年龄(OR 1.32,95%CI 1.08至1.61)均相关,而在排除左心室肥厚患者后,RWT增加仅与年龄相关(OR 1.61,95%CI 1.23至2.11)。对所有患者的单因素和多因素线性回归分析表明,即使考虑左心室结构变化,左心室舒张期超声心动图参数仅与年龄一致相关(p≤0.001)。

结论

无论左心室肥厚情况如何,年龄均与左心室向心性/功能性变化独立相关,提示衰老独立参与左心室重构的进展。

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