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目的研究老年高血压患者秋冬季节晨起血压变化的特点,为高血压患者的管理提供依据。方法在2012年秋、冬季对上海市静安区江宁街道所管辖的的老年高血压患者104例,非高血压人群116例连续测量5 d晨起坐位肱动脉血压,分析血压随季节变化的特点和差异。结果高血压患者冬季晨起收缩压、舒张压均显著高于秋季[分别为(137.2±8.5)mm Hg vs.(132.3±8.7)mm Hg、(83.5±6.3)mm Hg vs.(79.7±5.9)mm Hg,均P=0.0001)],非高血压患者仅舒张压冬季显著高于秋季[(77.8±4.3)mm Hg vs.(76.7±5.3)mm Hg,P=0.0031)];校正了年龄、BMI、体力活动、吸烟史、糖尿病史和高血脂史等数据的协方差分析表明,高血压患者舒张压增高的幅度[3.7(-9.4,28.4)mm Hg]显著大于非高血压人群[1.0(-13.6,16.2)mm Hg](P<0.001),收缩压增高的幅度[4.0(-16.4,26.8)]与非高血压人群[3.0(-11.2,21.2)mmHg]比较差异无统计学意义(P=0.107)。结论高血压患者冬季血压较秋季升高,舒张压增高幅度明显大于非高血压人群。应在冬季加强高血压患者的管理,减小血压波动。
Objective To study the characteristics of early morning blood pressure changes in elderly patients with hypertension in order to provide basis for the management of hypertensive patients. Methods In autumn and winter of 2012, 104 elderly hypertensive patients under the jurisdiction of Jiangning Street, Jing’an District, Shanghai were enrolled. 116 non-hypertensive patients were measured brachial artery blood pressure in morning sitting position for 5 days continuously. The characteristics and differences of blood pressure with seasons were analyzed . Results The systolic and diastolic blood pressure were significantly higher in patients with essential hypertension in early winter [(137.2 ± 8.5) mm Hg vs (132.3 ± 8.7) mm Hg, (83.5 ± 6.3) mm Hg vs. (79.7 ± 5.9) ) mm Hg, all P = 0.0001)], diastolic blood pressure alone in winter was significantly higher in non-hypertensive patients than in autumn [(77.8 ± 4.3) mm Hg vs. (76.7 ± 5.3) mm Hg, P = 0.0031) , BMI, physical activity, smoking history, history of diabetes mellitus and history of hyperlipidemia showed that the increase of diastolic blood pressure in hypertensive patients [3.7 (-9.4,28.4) mm Hg] was significantly greater than that of non-hypertensive patients [1.0 (-13.6,16.2) mm Hg] (P <0.001), and the magnitude of systolic blood pressure increase (4.0 (-16.4,26.8)] was not significantly different from that of non-hypertensive patients [3.0 (-11.2,21.2) mmHg] (P = 0.107). Conclusion The winter blood pressure of patients with hypertension is higher than that of autumn and the increase of diastolic blood pressure is obviously higher than that of non-hypertensive patients. Hypertensive patients should be managed in winter to reduce their blood pressure fluctuations.