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Young And Middle-aged And Older With Essential Hypertension Ambulatory Blood Pressure Characteristics And Analysis Of Risk Factors

Posted on:2009-05-07Degree:MasterType:Thesis
Country:ChinaCandidate:S J QinFull Text:PDF
GTID:2144360242980203Subject:Clinical Medicine
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Background: Hypertension is a important risk factor in cardio-cerebrovascular disease that effects the structure and function of the heart, the brain, kidney and other target organs, which eventually lead to the organ failure. As China has entered an ageing society, the prevalence of hypertension is increasing year by year. Patients with cardio-cerebrovascular disease caused by hypertension are increasingly obvious younger. So there is a higher demand of hypertension prevention, diagnosis, treatment and prognosis assessment. Current clinical diagnosis of hypertension still use the standard of casual blood pressure, because casual blood pressure provides small information, influential factors, can not reflect the 24-hour blood pressure changes and easily lead to misdiagnosis and missed diagnosis, however, 24-hour ambulatory blood pressure monitoring (Ambulatory Blood Pressure Monitoring, ABPM) one of the advantages is that we can monitor changes in blood pressure during sleep, good repeatability, more measurement values, no one reading error,helps in the diagnosis of hypertension and prediction on target organ damage (TOD), having been more attention on the diagnosis and treatment of hypertension value. Objective: Explore different age groups with essential hypertension (EH) ambulatory blood pressure characteristics and related risk factors contribute to the prevention of hypertension, guiding the treatment of hypertension and reduce the incidence of hypertension.Methods: Select October 2006 2008 March on the First Clinical Hospital of Jilin University comprehensive outpatient medical cadres and medical wards of the hospital have been diagnosed or the ambulatory blood pressure monitoring (ABPM) to define the diagnosis of 146 cases of young and middle-aged patients with EH and 141 cases of elderly EH patients as a research object, All patients were to ABPM are testing serum lipids, fasting blood glucose and renal function. Asked detailed genetic family history of hypertension, smoking history, history of alcohol and are engaged in high-tension of the work, and in accordance with the height and weight calculation of body mass index (BMI). ABPM the results of the retrospective analysis, statistical analysis of the relevant risk factors.Results: EH group aged 24 h, daytime and night-time dynamic PP level higher than the young and middle-aged EH group, 24 h, day and night EH DBP less than young and middle-aged group, between the two groups all P<0.05, there was significant difference between the two groups 24 hdMSBP, 24hnMSBP, 24hMSBP, P>0.05, with no statistical significance. EH group of young and middle-aged isolated systolic hypertension group,simply diastolic hypertension group, a mixed-hypertension group were 11 cases (7.53%), 52 cases (35.62%), 59 cases (40.41%), respectively aged 76 EH cases (53.90%), 16 cases (11.35%), 30 cases (21.28%), between the two groups, P<0.01, a significant difference。In the daytime blood pressure were normal, elevated blood pressure at night only accounted for 24 cases (16.43%) and 19 cases (13.46%), between the two groups P> 0.05, with no statistical significance. Young and middle-aged patients with EH group 146 cases of genetic family history of hypertension in 88 cases, 98 cases of smoking history, high-tension work in 96 cases, older EH group were 31 cases, 62 cases, 34 cases, the rate between the two groups, P < 0.01, a significant difference. EH group of young and middle-aged drinkers 84 cases, 52 patients with hyperlipidemia, obesity 82 cases, older EH group were 70 cases, 45 cases, 86 cases, the comparison between the two groups of P> 0.05, with no statistical significance.Conclusion: EH young and middle-aged group diastolic hypertension and hypertension mixed mainly elderly EH group to systolic hypertension and hypertension mainly mixed. ABPM hypertension can be found at night, the rate of increase in the diagnosis of hypertension, contribute to the early diagnosis of hypertension to avoid misdiagnosis and missed diagnosis, while the role of TOD forecast, it is promoting the use of the clinical Elderly EH group ambulatory blood pressure characteristics of PP is increasing significantly, analysis and the elderly EH group 24 h, day and night DBP decline。Increased pulse pressure in predicting the risk factors of hypertension play an important role.Young and middle-aged patients with EH in the genetic family history of hypertension, and actively improve the lifestyle, reducing stress, quitting smoking, such as hypertension and facilitate the prevention, to reduce the incidence of hypertension.
Keywords/Search Tags:middle-aged, young elderly, essential hypertension, ambulatory blood pressure characteristics, risk factors
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