Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
Eur Rev Med Pharmacol Sci. 2017 Dec;21(23):5451-5455. doi: 10.26355/eurrev_201712_13934.
To investigate the relationship between 24 h systolic blood pressure variability (SBPV) and target organ damage in elderly patients with essential hypertension.
180 elderly patients (≥ 80 y) with hypertension admitted to our hospital from January 2015 to January 2017 were selected as hypertension group and divided into high blood pressure variability (BPV) group and low BPV group according to the 50th percentile (P50) of 24 h SBPV, while 90 elderly non-hypertension patients admitted during the same period were enrolled as control group. 24 h ambulatory blood pressure values of patients in the three groups were recorded. The total cholesterol (TC), left ventricular mass index (LVMI), carotid artery intima-media thickness (IMT), 24 h microalbuminuria (MA) and complications with cardiovascular disease in patients of the three groups were compared and analyzed. Logistic analysis was conducted with MA, IMT and LVMI as the dependent variables and the remaining risk factors as the independent variables.
24 h SBPV and daytime SBPV (d SBPV) in patients of the hypertension group were significantly higher than those in the control group (p < 0.01); the incidences of coronary heart disease and atherosclerotic plaque as well as IMT, LVMI and MA were higher in the high BPV group than those in the low BPV group (p < 0.05 or p < 0.01). The multivariate results showed that 24 h SBPV was associated with IMT, LVMI and MA.
BPV can serve as an important indicator to predict target organ damage in elderly patients with essential hypertension. 24 h SBPV can reflect the degree of target organ damage in elderly hypertensive patients.
探讨老年原发性高血压患者 24 小时收缩压变异(SBPV)与靶器官损害的关系。
选择我院 2015 年 1 月至 2017 年 1 月收治的 180 例老年(≥80 岁)高血压患者为高血压组,根据 24 小时 SBPV 的第 50 百分位数(P50)分为高 SBPV 组和低 SBPV 组,同时选取同期收治的 90 例老年非高血压患者为对照组。记录三组患者 24 小时动态血压值,比较三组患者总胆固醇(TC)、左心室质量指数(LVMI)、颈动脉内膜中层厚度(IMT)、24 小时微量白蛋白尿(MA)及心血管疾病并发症发生情况,并以 MA、IMT 和 LVMI 为因变量,其余危险因素为自变量进行 Logistic 分析。
高血压组患者 24 小时 SBPV 和日间 SBPV(dSBPV)均明显高于对照组(p<0.01);高 SBPV 组患者冠心病、粥样硬化斑块及 IMT、LVMI、MA 发生率均明显高于低 SBPV 组(p<0.05 或 p<0.01)。多因素结果显示,24 小时 SBPV 与 IMT、LVMI 和 MA 相关。
BPV 可作为预测老年原发性高血压患者靶器官损害的重要指标,24 小时 SBPV 可反映老年高血压患者靶器官损害程度。