Research Of Postprandial Hypotension And Autonomic Nerve Function In Elderly Patients With Primary Hypertension

Background and objective:Postprandial hypotension(PPH) is a risk factor ofcardiovascular and cerebrovascular evens to elderly people.Autonomic nervous dysfunctionhas been considered as a major pathogenesis of PPH. Application of drugs also is a impactfactor of PPH. This research is to investigate the morbidity and pathogeny of PPH in theelderly patients with essential hypertension.Meanwhile to evaluate the impact ofanti-hypertension drugs on PPH and the damages of PPH in target organs.Methods: During the March to August in2013,123patients are selected from The FirstAffiliated Hospital of Dalian Medical University. The criteria of inclusion is according toWHO/ISH in1999: older than60years, the systolic blood pressure over140mmHg and (or)diastolic blood pressure over90mmHg. The exclusion criteria included secondaryhypertension, autonomic nerve failure, arrhythmia, heart failure, non-self-living ability. Thereare40men and83women involved with an average age of70.56±7.46. All patients took theirroutine medication during the study, meanwhile ABPM, Holter, color ultrasound ofextracranial carotid arteries and24-hour urinary protein quantity were used to evaluate themorbidity, HRV, risk factor and the damage of target organs of PPH. The statistical analysissoftware is SPSS19.0.Result: The incidence of PPH is71.5%. There are no significant difference between PPHgroup and non-PPH group in HRV. In addition，compared with non-PPH group, PPH grouphas more quantity of24h urinary protein and member with carotid plaque.Logistic regressionanalysis shows that aging, using ARB drugs increased the risk of PPH, acarbose reduced therisk of PPH.Conclusions:1. PPH is a common disease in elderly primary hypertension patients in this study.2.In elderly primary hypertension patients, autonomic nervous dysfunction maybe isn’t amajor pathogenesis of PPH.3.Elderly primary hypertension patients who with PPH have more damage in kidneyand artery. 4.The risk factors of PPH maybe including aging and using ARBs drugs, acarbosemaybe a protect factor of PPH.