老年人群中晨峰血压研究现状及管理策略-老年医学专业论文.docxVIP

重庆医科 重庆医科大学硕士研究生学位论文 万方数据 万方数据 英汉缩略语名词对照 英文缩写 英文全称 中文全称 BPV blood pressure ariability 血压变异性 MBPS morning surge in blood pressure 晨峰血压 ABPM ambulatory blood pressure monitoring SHATS systemic hemodynamic atherothrombotic syndrome 动态血压监测 系统性血流动力学动脉粥 样硬化血栓形成综合征 SBP systolic blood pressure 收缩压 DBP diastolic blood pressure 舒张压 MPV mean platelet volume 平均血小板体积 LVMI left ventricular mass index 左室质量指数 HRV heart rate variability 心率变异性 MMSE mini-mental state examination 简易智力状况检查法 HBPM home blood pressure monitoring 家庭血压监测 PBPM office blood pressure monitoring 诊室血压测量 COER control extend release 药物定时释放试剂 GRD graded-release 分级释放试剂 1 老年人群中晨峰血压研究现状及管理策略 摘要 高血压为世界公认最常见的慢性病，是导致心脏病、脑血管病、 肾脏病发病的最重要危险因素。高血压患者血压波动呈昼夜节律的特 征，把清晨血压急剧上升的现象称为晨峰血压，这与靶器官损害及心 血管终点事件的发生具有密切关系，尤其是在老年高血压患者人群中， 由于临床发病率高，知晓率、治疗率、控制率普遍低下，造成极高的 致残率和致死率，成为老年人健康的潜在危害，严重威胁老年人的生 命健康、影响其生活质量。随着我国人口老龄化进程的加速，老年高 血压患病率正在呈上升趋势，重视老年晨峰血压，并且采取针对性的 综合防治措施，对有效的控制高血压、降低老年减少靶器官损害、减 少心脑血管疾病、改善总体预后具有重要的意义。目前，晨峰血压对 靶器官的危害的相关性研究得到更多的重视，为临床工作中的指导作 用也越来越突出。现就晨峰血压的流行病学、定义及鉴别、病理生理 机制、危险因素、靶器官损害的关系、研究进展及管理策略等作出综 述。 关键词：血压变异性，晨峰血压，靶器官损害，管理策略 2 RESEARCH STATUS OF THE MORNING BLOOD PRESSURE SURGE IN ELDERLY PEOPLE AND MANAGEMENT STRATEGY ABSTRACT Hypertension is a world-wide and most common chronic disease. Hypertension is the important factor that causes heart disease, cerebrovascular disease, nephropathy. Blood pressure of patients with hypertension fluctuates differently between day and night. Blood pressure in the morning raises rapidly, which is called morning blood pressure surge, associated with damage of target organs and cardiovascular outcome event, particularly occurring in aged patients with hypertension. Because of high morbidity, low awareness rate, low rate of treatment and low control rate, hypertension leads to high disability rate and fatality rate, which potentially harm aged people, seriously threaten health of aged people and influence quality of their life. With aging progress of population accelerates, there is an ascendi