不同程度老年高血压患者24h动态血压变异特点及心脑血管事件发生情况

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Abstract Objective To investigate the characteristics of 24 h ambulatory blood pressure variability and the occurrence of cardiovascular and cerebrovascular events in elderly hypertensive patients with different degrees. Methods A total of 120 elderly hypertensive patients in Dongfeng Overseas Chinese Hospital from June 2017 to December 2018 were selected as research objects. According to the hypertension grade standard, they were divided into grade Ⅰ, gradeⅡand grade Ⅲgroups, with 40 cases in each group. All patients were applied dynamics. The ECG blood pressure recorder accurately records the 24 h ambulatory blood pressure, analyzes its variation characteristics and compares the occurrence of cardiovascular and cerebrovascular events among the three groups of patients. Results The diastolic blood pressure, the systolic blood pressure, the standard deviation (SD) of the diastolic blood pressure-ambulatory blood pressure curve, the coefficient of variability (CV) of the diastolic blood pressure-ambulatory blood pressure curve, the systolic blood pressure-CV and the systolic blood pressure-SD in the Ⅱand Ⅲgroups were higher than those of the grade Ⅰgroup, and the grade Ⅲgroup was higher than the grade Ⅱgroup, the differences were statistically significant (P<0.05). Comparison of the incidence of myocardial infarction and cerebral hemorrhage among the three groups was statistically significant (P<0.05). The incidence of myocardial infarction and cerebral hemorrhage in the grade Ⅲgroup was higher than that in the grade Ⅰgroup, and the difference was statistically significant (P<0.017). Conclusion The blood pressure variability index is the main influencing factor for the occurrence of cardiovascular and cerebrovascular events in elderly hypertensive people independent of blood pressure. The greater the blood pressure variability,the higher the incidence of cardiovascular and cerebrovascular events. Therefore, we should focus on the variability of blood pressure on the basis of strengthening the grading management of blood pressure, and propose targeted treatment methods for blood pressure levels and blood pressure variability to control the occurrence of diseases.

Key words： Elderly hypertension 24 h dynamic blood pressure variability Cardiovascular and cerebrovascular events;Cerebral hemorrhage Myocardial infarction

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