老年高血压合并冠心病患者动态血压特点分析

目的：观察老年高血压合并冠心病患者动态血压特点，探讨动态血压异常与冠状动脉粥样硬化的关系。方法：220例年龄大于60岁的老年高血压病患者根据冠状动脉造影结果分为高血压合并冠心病组（124例）和单纯高血压组（96例），对两组患者行动态血压监测，记录24h血压水平、血压变异性、脉压及血压昼夜节律。结果：与单纯高血压组比较，高血压合并冠心病组患者24h、白昼、夜间平均收缩压，收缩压变异性[白昼（14.01±4.26）比（17.54±5.51），夜间（15.05±4.01）比（19.32±3.71）]及脉压[白昼（56.66±7.43）mmHg比（66.32±13.62）mmHg，夜间（55.71±6.62）mmHg比（63.86±7.52）mmHg]均显著升高（P均＜0.05），非杓型节律比例明显增大（60.32％比82.45％，P＜0.01）。结论：老年高血压合并冠心病患者收缩压、脉压水平高，血压变异性大，昼夜节律异常者比例大，这些异常可能与冠状动脉粥样硬化的发生发展有关系。

Features of ambulatory blood pressure in aged patients with hypertension complicated coronary heart ;disease

Objective：To observe features of ambulatory blood pressure in aged patients With hypertension complicated coro-nary heart disease （CHD）and explore the relationship betWeen abnormal ambulatory blood pressure and coronary athero-sclerosis.Methods：According to coronary angiographic results,a total of 220 aged patients With hypertension （〉60 years） Were divided into hypertension＋ CHD group （n=124）and single hypertension group （n=96）.Both groups received 24h ambulatory blood pressure monitoring （ABPM）,24h blood pressure （BP）,BP variability,pulse pressure and circadian rhythm of blood pressure Were recorded.Results：Compared With single hypertension group,there Were significant increase in 24h,daytime,nighttime mean systolic blood pressure （SBP）,SBP variability [dSSD （14.01±4.26）vs. （17.54± 5.51）,nSSD （15.05±4.01）vs. （19.32±3.71）],pulse pressure [dPP （56.66±7.43）mmHg vs. （66.32±13.62） mmHg,nPP （55.71±6.62）mmHg vs. （63.86±7.52）mmHg] （P〈0.05 all）and percentage of non-dipper rhythm （60.32% vs.82.45%）in hypertension＋CHD group,P〈0.01.Conclusion：There are significant increase in systolic blood pressure,SBP variability and pulse pressure,percentages of abnormal circadian rhythm in aged patients With hyper-tension complicated coronary heart disease, these abnormality may be related to occurrence and development of coronary atherosclerosis in aged patients With hypertension.