目的 探讨高龄原发性高血压患者动态血压特点及其与靶器官受损程度的关系.方法 对80例年龄≥80岁的高血压患者进行24 h动态血压监测,根据夜间血压下降率分为杓型组38例和非杓型组42例,比较2组患者收缩压、舒张压、血压负荷值及靶器官受损的情况.结果 与杓型组比较,非杓型组24 h、昼间和夜间收缩压均明显升高(P＜0.05),非杓型组和杓型组24 h收缩压负荷值分别为(72.0±11.0)％ vs(32.0±8.0)％,P＜0.01.非杓型组服用降压药的种类数、冠心病、缺血性脑卒中、肾功能不全及外周动脉疾病的比例显著高于杓型组(P＜0.05).结论 高龄非杓型高血压患者的平均收缩压、收缩压负荷及靶器官损害发生率明显高于杓型患者,这类高血压患者更需合理控制血压.%Objective To investigate the feature of ambulatory blood pressure in dipper and non-dipper groups of very elderly hypertensive patients,and to assess the relationship between circadi-an rhythm abnormality and the incidence of target organ damage. Methods The 80 hypertensive patients were selected. Patients were divided into dipper group and non-dipper group according to nocturnal blood pressure fall rate by ambulatory blood pressure monitoring. SBP,DBP and blood pressure load and the incidence of target organ damage degree were recorded. Results 24 h systolic blood pressure load in non-dipper group and dipper group were respectively were respectively (72. 0±ll. 0)% vs (32. 0±8. 0)%. Medications needed in non-dipper group .and dipper group were significantly more than that in dipper group (P<0. 05). The incidence of coronary heart disease, ischemic stroke, renal dysfunction and peripheral arterial disease in non-dipper group were significantly higher than those in dipper group(P<0. 05). Conclusion In hypertensive patients aged 80 years and older,24 h,day and night systolic blood pressure and 24 h systolic blood pressure load in non-dipper group was significantly higher than that in dipper group respectively. The incidence of target organ damage in non-dipper group was significantly higher than that in dipper group. More optimal antihypertensive treatment are needed in these patients.
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