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≥80岁患者动态血压监测确定的难治性高血压的临床特征、靶器官损害及相关危险因素

Clinical characteristics, target organ damage and associate risk factors of resistant hypertension determined by ambulatory blood pressure monitoring in patients aged ≥ 80 years.

作者信息

Liang Zhi-Ru, Gao Ling-Gen, Cao Jian, Cui Hua, Fan Li, Gao De-Wei

机构信息

Department of Comprehensive Surgery, Chinese PLA General Hospital, Beijing, China.

Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China.

出版信息

J Geriatr Cardiol. 2017 May;14(5):308-314. doi: 10.11909/j.issn.1671-5411.2017.05.015.

DOI:10.11909/j.issn.1671-5411.2017.05.015
PMID:28630606
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5466933/
Abstract

OBJECTIVES

To investigate clinical characteristics, target organ damage, and the associated risk factors of the patients aged ≥ 80 years with true resistant hypertension (RH).

METHODS

Patients aged ≥ 80 years with hypertension ( = 1163) were included in this study. The included participants attended a structured clinical examination and an evaluation of RH was carried out. The prevalence, clinical characteristics and target organ damage of patients with RH were assessed. The associated clinical risk factors were analyzed by using logistic regression.

RESULTS

The prevalence of RH diagnosis by 24-h ambulatory blood pressure monitoring assessment was 21.15%. End-diastolic left ventricular internal dimension, left ventricular mass index as well as prevalence of left ventricular hypertrophy were significantly greater in patients with RH than in control group. The common carotid artery intimal media thickness, carotid walls thickness, common carotid artery diameter and relative wall thickness were significant greater in RH group than in control. A relatively higher level of creatinine, estimated glomerular filtration rate, microalbuminuria and retinal changes was found in RH group than in control. A multivariate analysis showed that patients with a history of diabetes, higher body mass index (BMI) and lipid profiles were independent risk factors of RH.

CONCLUSIONS

The prevalence of RH in patients aged ≥ 80 years was within the range of reported rates of the general population. Subjects with RH diagnosis showed a higher occurrence of target organ damage than patients with well controlled blood pressure. Patients with diabetes, higher BMI and serum lipid profiles were independent risk factors for RH in patients aged ≥ 80 years.

摘要

目的

探讨年龄≥80岁的真性难治性高血压(RH)患者的临床特征、靶器官损害及相关危险因素。

方法

本研究纳入年龄≥80岁的高血压患者(n = 1163)。纳入的参与者接受了结构化临床检查,并进行了RH评估。评估了RH患者的患病率、临床特征和靶器官损害情况。采用逻辑回归分析相关临床危险因素。

结果

通过24小时动态血压监测评估得出的RH诊断患病率为21.15%。RH患者的舒张末期左心室内径、左心室质量指数以及左心室肥厚患病率均显著高于对照组。RH组的颈总动脉内膜中层厚度、颈动脉壁厚度、颈总动脉直径和相对壁厚度均显著大于对照组。RH组的肌酐水平、估计肾小球滤过率、微量白蛋白尿和视网膜病变水平相对较高。多因素分析显示,有糖尿病史、较高的体重指数(BMI)和血脂水平是RH的独立危险因素。

结论

年龄≥80岁患者的RH患病率在一般人群报告的患病率范围内。诊断为RH的患者靶器官损害发生率高于血压控制良好的患者。糖尿病、较高的BMI和血脂水平是年龄≥80岁患者RH的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fac3/5466933/aa63aea94935/jgc-14-05-308-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fac3/5466933/aa63aea94935/jgc-14-05-308-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fac3/5466933/aa63aea94935/jgc-14-05-308-g001.jpg

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