老年人单纯收缩期高血压对心脑血管事件的影响调查研究
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摘要
目的探讨单纯收缩期高血压(ISH)对老年人群心脑血管事件的影响。方法选取2016年1月—2017年6月在该院心血管内科门诊治疗ISH 80例为治疗组,给予厄贝沙坦1次/d,口服150 mg的临床治疗,降压效果不理想者,每日剂量可增加至300 mg。治疗期间跟踪观察,并记录患者的血压、心率、空腹血糖、空腹胰岛素、三酰甘油、总胆固醇。另选取同期来医院进行健康体检老年人正常血压者80名作为对照组。对所有病例入选进行追踪随访,观察心脑血管事件发生情况。结果治疗组出现心绞痛3例,心肌梗死的有1例,脑出血1例,脑梗死2例,总发生率为8.75%,而对照组中,出现心绞痛1例,总发生率是1.25%,两组在心绞痛、脑出血、脑梗死与心肌梗死的心脑血管事件发生率上差异有统计学意义(χ~2=4.820,P<0.05)。结论单纯收缩期高血压是老年人心脑血管事件发生的独立危险因素,积极开展治疗与预防,对于降低心脑血管事件的发生率、病死率都有重要意义。
Objective To study the effect of senile hypertension with isolated systolic hypertension on the cardiovascular events. Methods 80 cases of ISH patients in the outpatient department of cardiovascular medicine as treatment group in our hospital from January 2016 to June 2017 were selected, and they used the irbesartan once per day, and took 150 mg irbesartan orally, for the patients with unsatisfactory antihypertensive effect, the dosage each day increased to 300 mg, and the blood pressure, heart rate, fasting blood glucose, fasting insulin, triacylglycerol and total cholesterol were recorded, and 80 cases of senile patients with normal blood pressure for healthy physical examination at the same period were selected as the control group, and all patients were traced and followed up, and the occurrence of cardiovascular events was observed. Results In the treatment group, there were 3 cases with angina pectoris, 1 case with myocardial infarction, 1 case with cerebral hemorrhage, 2 cases with cerebral infarction, and the total incidence rate was8.75%, in eh control group, there was 1 case with angina pectoris, and the total incidence rate was 1.25%, and the differences in the incidence rates of angina pectoris cerebral hemorrhage cerebral infarction and myocardial infarction cardiovascular events between the two groups were statistically significant(χ~2=4.820, P<0.05). Conclusion The isolated systolic hypertension is the independent risk factor of occurrence of senile patients with cardiovascular events, and the active development of treatment and prevention can be of important significance to reducing the incidence rate and morbidity of cardiovascular events.
Objective To study the effect of senile hypertension with isolated systolic hypertension on the cardiovascular events. Methods 80 cases of ISH patients in the outpatient department of cardiovascular medicine as treatment group in our hospital from January 2016 to June 2017 were selected, and they used the irbesartan once per day, and took 150 mg irbesartan orally, for the patients with unsatisfactory antihypertensive effect, the dosage each day increased to 300 mg, and the blood pressure, heart rate, fasting blood glucose, fasting insulin, triacylglycerol and total cholesterol were recorded, and 80 cases of senile patients with normal blood pressure for healthy physical examination at the same period were selected as the control group, and all patients were traced and followed up, and the occurrence of cardiovascular events was observed. Results In the treatment group, there were 3 cases with angina pectoris, 1 case with myocardial infarction, 1 case with cerebral hemorrhage, 2 cases with cerebral infarction, and the total incidence rate was8.75%, in eh control group, there was 1 case with angina pectoris, and the total incidence rate was 1.25%, and the differences in the incidence rates of angina pectoris cerebral hemorrhage cerebral infarction and myocardial infarction cardiovascular events between the two groups were statistically significant(χ~2=4.820, P<0.05). Conclusion The isolated systolic hypertension is the independent risk factor of occurrence of senile patients with cardiovascular events, and the active development of treatment and prevention can be of important significance to reducing the incidence rate and morbidity of cardiovascular events.
引文
[1]国家基本公共卫生服务项目基层高血压管理办公室、基层高血压管理专家委员会.《国家基层高血压防治管理指南(2017)》[J].中国循环杂志,2017,32(11):1041-1047.
[2]中国高血压基层管理指南修订委员会.《中国高血压基层管理指南(2014修订版)》[J].中华高血压杂志,2015,23(1):24-41.
[3]廖立,何杰,刘琼,等.高血压患者颈动脉硬化的危险因素分析[J].转化医学电子杂志,2015, 2(5):14-15.
[4]王蕴强.老年单纯性收缩期高血压的诊疗进展[J].中国医药指南杂志,2016, 14(7):31.
[5]李宁,刘坤.老年单纯收缩期高血压中医辨证思路[J].中国临床医生杂志,2016,44(5):4-6.
[6]张立建,李慧敏,钟惠娟,等.老年人单纯收缩期高血压对心脑血管病的影响[J].河北医药杂志,2017, 39(1):105-110.
[7]郑培省.单纯收缩期高血压对老年人群心脑血管事件的影响[J].当代医学杂志,2016, 22(29):72-73.
[8]梁建尤.单纯收缩期高血压对老年人群心脑血管事件的影响[J].现代诊断与治疗杂志,2016,27(21):4125-4126.
[9]杨海见,李维真,刘安恒,等.老年单纯收缩期高血压患者颈动脉病变76例分析[J].浙江中西医结合杂志,2010,20(7):418-419.
[10]包秋红,曹中朝.老年单纯收缩期高血压的相关研究[J].内蒙古医学杂志,2007,39(5):591-593.
[2]中国高血压基层管理指南修订委员会.《中国高血压基层管理指南(2014修订版)》[J].中华高血压杂志,2015,23(1):24-41.
[3]廖立,何杰,刘琼,等.高血压患者颈动脉硬化的危险因素分析[J].转化医学电子杂志,2015, 2(5):14-15.
[4]王蕴强.老年单纯性收缩期高血压的诊疗进展[J].中国医药指南杂志,2016, 14(7):31.
[5]李宁,刘坤.老年单纯收缩期高血压中医辨证思路[J].中国临床医生杂志,2016,44(5):4-6.
[6]张立建,李慧敏,钟惠娟,等.老年人单纯收缩期高血压对心脑血管病的影响[J].河北医药杂志,2017, 39(1):105-110.
[7]郑培省.单纯收缩期高血压对老年人群心脑血管事件的影响[J].当代医学杂志,2016, 22(29):72-73.
[8]梁建尤.单纯收缩期高血压对老年人群心脑血管事件的影响[J].现代诊断与治疗杂志,2016,27(21):4125-4126.
[9]杨海见,李维真,刘安恒,等.老年单纯收缩期高血压患者颈动脉病变76例分析[J].浙江中西医结合杂志,2010,20(7):418-419.
[10]包秋红,曹中朝.老年单纯收缩期高血压的相关研究[J].内蒙古医学杂志,2007,39(5):591-593.