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目的探讨老年高血压患者诊室血压和动态血压达标情况及影响因素。方法在参加2010-2011年度健康体检的开滦离退休员工中整群抽取年龄≥60岁的2814人进行动态血压监测,符合入选标准者2464人,分析其中754例服用抗高血压药物的老年高血压患者诊室血压达标(诊室血压<140/90mm Hg)和24h动态血压达标(24h平均血压<130/80mm Hg)情况。采用Logistic回归分析影响老年高血压患者动态血压不达标的相关因素。结果老年高血压患者754例中,诊室血压达标率19.2%(95%CI16.4%~22.0%),24h动态血压达标率33.6%(95%CI30.2%~37.0%)。诊室血压达标的145例老年高血压患者中,24h动态血压达标率为51.0%(95%CI42.9%~59.1%),男性、体质量指数(BMI)是24h动态血压不达标的危险因素,OR值(95%CI)分别为2.942(1.155~7.498),1.195(1.031~1.386)。诊室血压不达标的609例老年高血压患者中,24h动态血压达标率为29.4%(95%CI25.8%~33.0%),男性、诊室收缩压、BMI是24h动态血压不达标的危险因素,OR值(95%CI)分别为1.679(1.125~2.506),1.030(1.019~1.042),1.067(1.007~1.130)。结论老年高血压患者诊室血压和动态血压达标率低,男性、BMI、诊室收缩压是影响24h动态血压不达标的危险因素。
Objective To investigate the compliance and influencing factors of blood pressure and ambulatory blood pressure in the elderly patients with hypertension. Methods A total of 2,814 people aged 60 or older who were retired from Kailuan participating in the 2010-2011 health examination were enrolled in the study. Ambulatory blood pressure monitoring was performed in 2464 eligible patients, of which 754 were elderly patients with antihypertensive drugs Clinic blood pressure in patients with blood pressure compliance (clinic blood pressure <140 / 90mm Hg) and 24h ambulatory blood pressure (24h average blood pressure <130 / 80mm Hg) situation. Logistic regression analysis was used to analyze the related factors that affect ambulatory blood pressure in elderly hypertensive patients. Results Among the 754 elderly hypertensive patients, the compliance rate of clinic was 19.2% (95% CI 16.4% -22.0%), and the standard of 24h ambulatory blood pressure was 33.6% (95% CI 30.2% -37.0%). Among 145 elderly hypertensive patients with blood pressure compliance in clinic, the compliance rate of 24h ambulatory blood pressure was 51.0% (95% CI 42.9% -59.1%), and the male body mass index (BMI) was the risk factor of ambulatory 24-hour non- OR (95% CI) were 2.942 (1.155 ~ 7.498) and 1.195 (1.031 ~ 1.386), respectively. The prevalence rate of ambulatory blood pressure was 29.4% (95% CI25.8% -33.0%) in 609 elderly hypertensive patients with non-compliance blood pressure in clinic, systolic blood pressure in male and clinic, BMI was the risk factor of ambulatory blood pressure non-compliance in 24h, OR values (95% CI) were 1.679 (1.125-2.506), 1.030 (1.019-1.042) and 1.067 (1.007-1.130), respectively. Conclusion The prevalence of ambulatory blood pressure and ambulatory blood pressure is low in elderly hypertensive patients. The systolic blood pressure in men, BMI and clinic is the risk factor for non-compliance of 24h ambulatory blood pressure.