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动态血压监测在衰弱老年患者隐匿性高血压及其他现象检测中的关键作用。

The Key Role of Ambulatory Blood Pressure Monitoring in the Detection of Masked Hypertension and Other Phenomena in Frail Geriatric Patients.

机构信息

Department of Exercise Medicine and Cardiovascular Rehabilitation, Palacký University Olomouc and University Hospital Olomouc, 77520 Olomouc, Czech Republic.

Department of Internal Medicine, FRANZISKUS SPITAL GmbH, Landstraßer Hauptstraße 4a, 1030 Vienna, Austria.

出版信息

Medicina (Kaunas). 2021 Nov 9;57(11):1221. doi: 10.3390/medicina57111221.

Abstract

: This study aims to determine prevalence of masked uncontrolled hypertension (MUH) in frail geriatric patients with arterial hypertension and thus show the role of ambulatory blood pressure monitoring (ABPM) since hypertension occurs in more than 80% of people 60+ years and cardiovascular diseases are the main cause of death worldwide. Despite modern pharmacotherapy, use of combination therapy and normal office blood pressure (BP), patients' prognoses might worsen due to inadequate therapy (never-detected MUH). : 118 frail geriatric patients (84.2 ± 4.4 years) treated for arterial hypertension with office BP < 140/90 mmHg participated in the study. 24-h ABPM and clinical examination were performed. : Although patients were normotensive in the office, 24-h measurements showed that BP values in 72% of hypertensives were not in the target range: MUH was identified in 47 (40%) patients during 24 h, in 48 (41%) patients during daytime and nocturnal hypertension in 60 (51%) patients. : ABPM is essential for frail geriatric patients due to high prevalence of MUH, which cannot be detected based on office BP measurements. ABPM also helps to detect exaggerated morning surge, isolated systolic hypertension, dipping/non-dipping, and set and properly manage adequate treatment, which reduces incidence of cardiovascular events and contributes to decreasing the financial burden of society.

摘要

本研究旨在确定衰弱的老年高血压患者中隐匿性未控制高血压(MUH)的患病率,从而展示动态血压监测(ABPM)的作用,因为高血压在 60 岁以上人群中发生率超过 80%,心血管疾病是全球主要的死亡原因。尽管采用了现代药物治疗、联合治疗和正常诊室血压(BP),但由于治疗不足(从未检测到的 MUH),患者的预后可能会恶化。本研究纳入了 118 名接受动脉高血压治疗且诊室血压<140/90mmHg 的衰弱老年患者(84.2±4.4 岁)。进行了 24 小时 ABPM 和临床检查。尽管患者在诊室血压正常,但 24 小时测量结果显示,72%的高血压患者的血压值不在目标范围内:24 小时内有 47 名(40%)患者存在 MUH,48 名(41%)患者日间存在高血压,60 名(51%)患者夜间存在高血压。对于衰弱的老年患者,ABPM 至关重要,因为 MUH 患病率很高,不能仅根据诊室 BP 测量来检测。ABPM 还有助于检测清晨血压剧烈波动、孤立性收缩期高血压、杓型和非杓型血压以及设定和适当管理适当的治疗,从而降低心血管事件的发生率,并有助于减轻社会的经济负担。

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