Application Of Ambulatory Blood Pressure Monitoring In Elderly Hypertensive Patients

Objectives: Amulatory blood pressure monitoring (ABPM) has been usedwidely in research and clinical practice and may be hoped to become animPortam new means in diagnosis, risk estimation and treatment evaluationof hypertension. Ambulatory blood pressure (ABP), in comparison withclinic blood pressure (CBP), is more reproducible, more closely related withtarget organ damage and more better to estimate the risk of complications.To observe and analyze the characteristic of ABP in elderly hypertensivepatients, the effect of aging to ABP and explore the relationship of ABPwith TOD and prognosis, this survey was performed. Methods: Collectingand collating the data of patients who was performed ABPM in ourdepartment between April, 1996 and May, 2000, ABP and CBP ABP ofhypertensive and non-hypertensive patients were compared and thedifference among them were described and analyzed. Dividing the subjectsinto three age groups, the effect of aging to ABP parameters were analyzedand compared. According to the TOD the hypertensive patients weredivided into four grouPs, the similarities and differences of their ABPparameters were comPared. 69 patieflts whose data were illtegrated andcontinued were conducted the retfo-prospective analysis.Results: The ABP characteristics of elderly hypertensive patients mainlyshowed high systolic blood pressure (SBP), wide pulse pressure (PP) andlower noctumal blood pressure decline although easily fluctuating, and alsoshowed less noctumal reduction and blunted day-nigh rhythm in the elderlynon-hypertensive patients. All of indexes of SBP diastolic blood pressure(DBP) and PP among three age groups in elderly hypertensive patientsdiffered significat1y. SBP of the grouP 60- were lower than the grouP 70-and 80-, Whereas their DBP were higher than the latter two grouPs. Thevalues of PP all presented the trend of increase following the rise of age.The circadian blood pressure (BP) curve of the group 60- aPproximatelyliked dipper pattem whereas the laller two grouPs' were non-diPPerpattems with two peaks and two troughs. The comparison of ABPparameters among various TOD grouPs showed that the indexes of SBP andPP differed significanly among various grouPs, and were lowest inthe non-organ damaged grouP and highest in the kidney damaged grouP.The circadian BP curve of group non-damaged was smooth and steady butnoctoal reduction was less than 10%. The curves of grouP heart and braindamaged were the similar non-dipper patterns of two peaks and two troughsand showed a BP surge in the moming. The time of noctumal reduction wasdelayed in grouP kidney damaged and reduction amPlitude was lowerThe retro-prospective analysis showed that the adverse events rate of grouPI (24hSBP