Thijs L, Dabrowska E, Clement D, Fagard R, Laks T, Mancia G, O'Brien E, Omboni S, Parati G, Staessen J
Hypertension Unit, UZ Gasthuisberg O & N, Leuven, Belgium.
J Hum Hypertens. 1995 Nov;9(11):917-24.
This study describes the diurnal blood pressure (BP) profile and identifies its correlates in older patients with isolated systolic hypertension (ISH). The ambulatory BP readings of 408 patients, aged > or = 60 years, with ISH on clinic measurement, enrolled in the placebo run-in phase of the Syst-Eur Trial were examined. The time-weighted 24 h BP, daytime and night-time BP and the cusum-derived crest and trough BP were computed to express the BP level. The daily alteration between the high and low BP span was estimated from the day-night BP difference, the cusum derived circadian alteration magnitude and plot height, as well as the amplitude of the Fourier curve. The 24 h SBP and DBP tended to be higher in men (150 +/- 15/82 +/- 9 mm Hg) than in women (147 +/- 17/79 +/- 10 mm Hg), but the sex difference was only significant for DBP. In multiple regression analysis, the 24 h SBP increased (P < 0.05) by 3 mm Hg for each 10 year increment in age and was also 10 mm Hg higher (P < 0.001) in smokers than in non-smokers; the 24 h DBP was 2 mm Hg higher (P < 0.05) in men than in women and decreased (P < 0.05) by 1.5 mm Hg for each 10 year increment in age. The day-night difference in SBP increased with 2 mm Hg for each 10 mm Hg increase in the conventional pressure, decreased with 5 mm Hg for each 10 year increment in age and was 6 mm Hg higher in smokers than in non-smokers; the day-night difference in diastolic pressure was 2 mm Hg greater in women than in men. We conclude that the main determinants of the diurnal BP variation in older patients with isolated systolic hypertension were sex, age, smoking habits and the level of pressure on conventional measurement.
本研究描述了老年单纯收缩期高血压（ISH）患者的昼夜血压（BP）变化情况，并确定了其相关因素。对参加Syst-Eur试验安慰剂导入期的408例年龄≥60岁、临床测量诊断为ISH的患者进行了动态血压读数检查。计算时间加权24小时血压、白天和夜间血压以及累积和法得出的峰压和谷压，以表示血压水平。根据昼夜血压差值、累积和法得出的昼夜变化幅度和曲线高度以及傅里叶曲线的振幅，估算血压高低跨度之间的每日变化情况。24小时收缩压（SBP）和舒张压（DBP）在男性（150±15/82±9毫米汞柱）中往往高于女性（147±17/79±10毫米汞柱），但性别差异仅在DBP方面具有统计学意义。在多元回归分析中，年龄每增加10岁，24小时SBP升高3毫米汞柱（P<0.05），吸烟者的24小时SBP比非吸烟者高10毫米汞柱（P<0.001）；24小时DBP男性比女性高2毫米汞柱（P<0.05），年龄每增加10岁降低1.5毫米汞柱（P<0.05）。传统血压每升高10毫米汞柱，SBP的昼夜差值增加2毫米汞柱，年龄每增加10岁降低约5毫米汞柱，吸烟者的SBP昼夜差值比非吸烟者高6毫米汞柱；女性的舒张压昼夜差值比男性大2毫米汞柱。我们得出结论，老年单纯收缩期高血压患者昼夜血压变化的主要决定因素是性别、年龄、吸烟习惯和传统测量的血压水平。
