Kohara K, Igase M, Yinong J, Fukuoka T, Maguchi M, Okura T, Kitami Y, Hiwada K
Second Department of Internal Medicine, Ehime University School of Medicine, Japan.
Am J Hypertens. 1997 Aug;10(8):829-35. doi: 10.1016/s0895-7061(97)00116-7.
To investigate the underlying mechanisms of asymptomatic cerebrovascular damage, the diurnal change in blood pressure was evaluated in hypertensive patients with silent cerebral infarction (SCI). Sixty elderly hypertensive patients (age > or = 60 years) were matched with 40 middle-aged patients (age < or = 59 years) for sex and left ventricular mass index (LVMi). Lacunar lesions were evaluated by magnetic resonance imaging as SCI. The presence and the severity of SCI increased with age. In the middle-aged group, the presence of SCI was significantly related to 24-h blood pressure and LVMi evaluated by echocardiography. In elderly patients, the presence of SCI had no relationship with 24-h blood pressure or LVMi. The lowest level of nocturnal diastolic blood pressure showed a J-shaped relationship with the incidence of SCI in the elderly patients. These findings indicate that the hemodynamic characteristics underlying the development of SCI differ between middle-aged and elderly hypertensive patients. A different approach to the treatment of hypertension in the elderly appears necessary.
为研究无症状脑血管损伤的潜在机制，我们对患有无症状脑梗死（SCI）的高血压患者的血压昼夜变化进行了评估。60名老年高血压患者（年龄≥60岁）与40名中年患者（年龄≤59岁）在性别和左心室质量指数（LVMi）方面进行了匹配。通过磁共振成像评估腔隙性病变作为SCI。SCI的存在和严重程度随年龄增加而增加。在中年组中，SCI的存在与通过超声心动图评估的24小时血压和LVMi显著相关。在老年患者中，SCI的存在与24小时血压或LVMi无关。老年患者夜间舒张压的最低水平与SCI的发生率呈J形关系。这些发现表明，中年和老年高血压患者中SCI发生的血流动力学特征不同。老年高血压的治疗似乎需要采用不同的方法。
