Clinical Characteristics And Ambulatory Blood Pressure Differences Of Resistant Hypertensionpatientsin Different Age

?Objective?To investigate the clinical characteristics and ambulatory blood pressure differences of resistant hypertension(RH)at different ages,so as to provide basis for clinical treatment of RH patients.?Research objects and methods?670 cases of hospitalized patients with RH in Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2010 to2015 August was observed,and it was divided into three groups according to age(?40years;41~59years;?60 ? years),analysis of the clinical characteristics and ambulatory blood pressure differences of RH patients in each group according to the age.In order to further study the characteristics and risk factors of hypertension in young and elderly RH patients,screening of young group(140 cases,18 ~ 40 years old)and the elderly group(140cases,aged?60years old);At the same time,the youth and elderly control groups were collected by matching age and sex.To compare the differences ofambulatory blood pressure index between the young and old RH patientgroup and the control group,and analyze the risk factors of hypertension in the young and elderly with logistics regression.?Result?1.The Overall male ratio was higher than that of female,reach 64.2%;In?60 years old groups,male accounted for the major part,the younger male ratio is greater;The proportion of female increased with age,and the proportion of female in ?60group increased to54.1%.The course of disease increased with age in RH patients(r=0.48),e GFR decreased with age(r=-0.39),(p<0.05).2.Clincal systolic blood pressure,clincal diastolic blood pressure in3 groups of RHPatients are statistically significant different,p<0.05.24 hdiastolic pressure and heart rate decreased with age in RH patients(r=-0.52;r=-0.17),the 24 h ambulatory pulse pressure difference increased with age(r=0.49)(p<0.05).3.24 hours diastolic blood pressure?Daytime diastolic pressure?nighttime diastolic blood pressure?24-hour heart rate?Daytime mean heart rate?nocturnal mean heart rateof young RH patientgroup were higher than old RH patient group(p<0.01)[(91±9)mm Hg vs(74±9)mm Hg,(93±10)mm Hgvs(71±9)mm Hg,(87±11)mm Hg vs(71±10)mm Hg,(72±9)times/minvs(65±8)times/min,75±10Times /min vs(67±8)times /min,(65±10)times/min vs(61±8)times/min];and 24 h PPwere lower than old RH patient group(p<0.01)[(49±9)mm Hg vs(68±11)mm Hg];4.24 h ambulatory pulse pressure,nocturnal heart rateof young RH patient group is higher than the young control group [(49±9)mm Hg vs(44±6)mm Hg,65±10)times/min vs(63±7)times /min],nocturnal blood pressure decline rate is lower[(4.78 ± 8.12)%vs(8.12 ±6.63)%](p<0.01).5.24 hpulse pressure,diastolic blood pressure variationof old RH patient group is higher than the old control group [(68 ±11)than mm Hg(55±10)mm Hg,(11.3 ± 3.4)% vs(12.9 ± 3.7)% ],nocturnal blood pressure decline rateis lower [(3.6± 7.1)% vs(5.9±7.6)%](P < 0.05).6.Multivariate regression analysis in young RH patientgroup showed that24 h ambulatory pulse pressure [? 0.046,OR 1.047,95%CI 1.005-1.091],interventricular septum thickness [?,OR 1.77,95%CI 1.452-2.157] are independent risk factors for young RH patients.7.Multivariate regression analysis in elderly RH patientgroup patients showed that the 24 h ambulatory pulse pressure [? 0.102,OR1.108,95%CI1.058-1.16],nocturnal blood pressure decline rate [?-0.064,OR 0.938,95%CI0.886-0.993],duration of disease [? 0.082,OR1.085,95%CI1.052-1.119],diabetes [? 0.893,OR 2.442,95%CI,1.051-5.675] are independent risk factors for elderly patients with RH.?Conclusion?1.Among RH patients,Glomerular filtration rate decreased with the increase of age and the course of disease increased with the increase of age,in different age groups and the proportion of women in RH increased with age.2.The mean diastolic pressure and heart rate decreased with the increase of age,and the 24-hour pulse pressure increased with age in patients with RH.3.24 h PP is a common independent risk factors in both young and elderly RH;diabetes is an independent risk factor of elderly RH patients.To sum up,through the analysis of 670 cases of RH patients with different ages,there was no obvious homogeneity and instead have differences in the clinical characteristics such as sex composition and course of disease,ambulatory blood pressure,and risk factors of hypertension,RH patients according to the different age should take corresponding treatment measures.