老年者高血圧症における血圧日内変動の検討 : 夜間血圧および早朝血圧の意義について

概要

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In order to determine the characteristics of the circadian variation of blood pressure in elderly hypertensives, we performed ambulatory blood pressure monitoring in 173 elderly outpatients whose 24-hour average systolic blood pressure was more than 135 mmHg. Nocturnal decline of blood pressure diminished with advancing age. Especially, the blood pressure difference between day and night in patients more than 80 years old was 9.8 mmHg which was significantly lesser than that of patients aged 60～69 years (p<0.05). Therefore, the incidence of non-dippers increased with advancing age. In 81 patients who underwent echocardiography, the left ventricular mass index was significantly correlated with the nighttime systolic blood pressure (r=0.42, p=0.0001) with which it was more closely correlated than the 24-hour (r=0.36, p=0.0008), daytime (r=0.29, p=0.009), or the casual systolic blood pressure (r=0.28, p=0.013). The morning surge of blood pressure was negatively correlated with the nighttime blood pressure (r= -0.31, p=0.0001). Accordingly, the left ventricular mass index did not correlate with the morning surge probably because of offset of the lower nighttime blood pressure in patients with a morning surge.
1996-12-25