Watanabe Y, Toyoshima T, Otsuka K, Watanabe H, Suzuki Y, Kuwajima I, Halberg F
First Department of Medicine, Second Hospital, Tokyo Women's Medical College.
Nihon Ronen Igakkai Zasshi. 1994 Mar;31(3):219-25. doi: 10.3143/geriatrics.31.219.
The effects of ageing on nocturnal blood pressure (BP) and the circadian rhythm of BP were studied. Ambulatory BP and heart rate (HR) were monitored at 30-minute intervals for 24 hours, in 326 normotensive volunteers aged 15-83. The following groups were monitored: young: < 40 yrs, n = 177; middle: 40 yrs < or = - < 60 years, n = 100; old: 60 yrs < or =, n = 49 Firstly, the ratio of nocturnal fall (RONF) of BP (or HR) was calculated as follows: [(average day time BP (or HR)-average night time BR (or HR)]/averaged whole day BP (or HR) x 100. Then we calculated 2 measurements: 1. The dipper (RONF of BP (or HR) > or = 10% 2. The non-dipper. (RONF of BP (or HR) < 10%. A cosine fitting technique using the least-squares method was employed to find the circadian rhythm of BP and HR. The results of the study showed that the incidence of the non-dipper on systolic BP (SBP) was higher for old subjects than for young subjects. In addition, the nocturnal BP and HR were higher for old subjects than for young subjects. The circadian amplitude of HR was lower in old subjects. The circadian midline estimating statistic of rhythm (MESOR) or SBP increased with age. The circadian acrophase of BP and HR increased with age.
non-dippers of BP and HR were observed in any age groups. The frequency of BP and HR non-dipper was greater for old subjects than young subjects. This result may suggest the clinical significance of nocturnal BP and HR for the evaluation of hypertensive subjects.
研究了衰老对夜间血压(BP)及血压昼夜节律的影响。对326名年龄在15 - 83岁的血压正常志愿者进行24小时动态血压和心率(HR)监测,监测间隔为30分钟。监测的分组如下:青年组:<40岁,n = 177;中年组:40岁≤ - <60岁,n = 100;老年组:60岁≤,n = 49。首先,血压(或心率)的夜间下降率(RONF)计算如下:[(日间平均血压(或心率) - 夜间平均血压(或心率))/全天平均血压(或心率)]×100。然后我们计算两项指标:1. 杓型(血压(或心率)的夜间下降率≥10%);2. 非杓型(血压(或心率)的夜间下降率<10%)。采用最小二乘法的余弦拟合技术来确定血压和心率的昼夜节律。研究结果显示,老年受试者收缩压(SBP)非杓型的发生率高于青年受试者。此外,老年受试者的夜间血压和心率高于青年受试者。老年受试者心率的昼夜振幅较低。血压的昼夜节律中线估计统计量(MESOR)或收缩压随年龄增加而升高(此处英文原文表述有误,推测应为收缩压的昼夜节律中线估计统计量随年龄增加而升高)。血压和心率的昼夜峰值相位随年龄增加。
在任何年龄组均观察到血压和心率的非杓型。老年受试者血压和心率非杓型的频率高于青年受试者。这一结果可能提示夜间血压和心率在评估高血压受试者方面的临床意义。