季节气象因素对高龄老年原发性高血压病患者血压波动的影响

doi:10.11958/20220213

天津医药 ›› 2022, Vol. 50 ›› Issue (11): 1196-1200.doi: 10.11958/20220213

季节气象因素对高龄老年原发性高血压病患者血压波动的影响

毕伟轩¹(), 张宇¹, 王仲言¹, 董琪¹, 崔宏艳¹, 王林¹, 李新²^,³^,^△()

1 天津医科大学第二医院保健医疗部老年病科（邮编300211）
2 神经内科
3 天津市健康气象交叉创新中心

收稿日期:2022-02-22 修回日期:2022-07-19 出版日期:2022-11-15 发布日期:2022-11-11
通讯作者: 李新 E-mail:498408707@qq.com;jessielx@126.com
作者简介:毕伟轩（1988），男，主管护师，主要从事动态血压、动态心电图分析研究。E-mail：498408707@qq.com
基金资助:
中国脑卒中高危人群干预适宜技术研究及推广项目(GN-2020R0005)

Influence of seasonal meteorological factors on blood pressure fluctuation in elderly patients with essential hypertension

BI Weixuan¹(), ZHANG Yu¹, WANG Zhongyan¹, DONG Qi¹, CUI Hongyan¹, WANG Lin¹, LI Xin²^,³^,^△()

1 Department of Geriatrics, Tianjin 300211, China
2 Department of Neurology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
3 Health Meteorological Cross Innovation Center of Tianjin

Received:2022-02-22 Revised:2022-07-19 Published:2022-11-15 Online:2022-11-11
Contact: LI Xin E-mail:498408707@qq.com;jessielx@126.com

毕伟轩, 张宇, 王仲言, 董琪, 崔宏艳, 王林, 李新. 季节气象因素对高龄老年原发性高血压病患者血压波动的影响[J]. 天津医药, 2022, 50(11): 1196-1200.

BI Weixuan, ZHANG Yu, WANG Zhongyan, DONG Qi, CUI Hongyan, WANG Lin, LI Xin. Influence of seasonal meteorological factors on blood pressure fluctuation in elderly patients with essential hypertension[J]. Tianjin Medical Journal, 2022, 50(11): 1196-1200.

摘要/Abstract

摘要：

目的分析不同季节气温变化对高龄老年原发性高血压病患者血压波动的影响。方法纳入高龄老年原发性高血压病的住院患者。收集患者一般资料、24 h动态血压数据、血浆同型半胱氨酸（Hcy）水平和佩戴动态血压计当日的气象资料，比较不同性别、不同季节血压值及血压波动情况，分别探讨气温和Hcy对原发性高血压患者血压的影响。结果男性的24 h平均收缩压（24 hSBP）、24 h收缩压标准差（24 hSSD）、24 h脉压指数（24 hPPI）均高于女性，男性的脑卒中病史比例高于女性。季节分组结果显示，24 hSBP表现为冬季最高，春秋次之，夏季最低；冬季24 hSSD、24 hPPI高于其他季节。低温组中，H型高血压组24 hSSD较高，24 hSSD与Hcy呈正相关。春、夏、秋3个季节日平均气温与24 hSBP呈线性负相关。日平均气温每升高1 ℃，24 hSBP降低0.641 mmHg。结论高龄老年原发性高血压病患者血压存在季节性波动，其中H型高血压病患者对寒冷更敏感。

关键词: 高血压, 温度, 高半胱氨酸, 老年人, 动态血压监测

Abstract:

Objective To analyze the influence of temperature changes in different seasons on blood pressure fluctuation in very old patients with essential hypertension. Methods Elderly inpatients with essential hypertension were included in this study. The general data of 24-hour ambulatory blood pressure, plasma homocysteine (Hcy) level and meteorological data of the day obtained by wearing ambulatory sphygmomanometer were collected. Blood pressure values and fluctuations of blood pressure in different sexes and different seasons were compared. Effects of temperature and Hcy on blood pressure in essential hypertensive patients were discussed. Results The 24 h mean systolic blood pressure (24 hSBP), the 24 h standard deviation of systolic blood pressure (24 hSSD) and the 24 h pulse pressure index (24 hPPI) were higher in males than those of females, and the proportion of stroke history was higher in males than that in females. The results of seasonal grouping showed that 24 hSBP was the highest in winter, followed by spring and autumn, and the lowest in summer. The 24 hSSD and 24 hPPI were higher in winter than those in other seasons. In the hypothermia group, 24 hSSD was higher in the type H hypertension group, and it was positively correlated with Hcy. The daily average temperature in spring, summer and autumn was negatively correlated with 24 hSBP. The 24 hSBP decreased by 0.641 mmHg when the daily mean temperature increased by 1 ℃. Conclusion The blood pressure of very old patients with essential hypertension fluctuates seasonally. Patients with H hypertension are more sensitive to cold.

Key words: hypertension, temperature, homocysteine, aged, ambulatory blood pressure monitoring

中图分类号:

R544.1

图/表 4

参考文献 20

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性别	n	年龄（岁）	脑卒中史		Hcy（μmol/L）		24 hSBP（mmHg）
男	246	86.9±4.57	88（35.8）		15.59±7.16		139.36±14.05
女	192	86.3±3.72	42（21.9）		15.09±6.79		133.86±14.18
t或χ²		0.138	9.979^＊		0.621		3.214^＊＊
性别	24 hDBP（mmHg）			24 hSSD（%）		24 hDSD（%）		24 hPPI
男	67.44±8.78			14.11±4.21		8.52±1.98		0.52±0.06
女	66.97±8.14			13.41±3.08		8.31±2.12		0.49±0.06
t或χ²	0.983			1.916^＊		0.989		4.397^＊＊

性别	n	年龄（岁）	脑卒中史		Hcy（μmol/L）		24 hSBP（mmHg）
男	246	86.9±4.57	88（35.8）		15.59±7.16		139.36±14.05
女	192	86.3±3.72	42（21.9）		15.09±6.79		133.86±14.18
t或χ²		0.138	9.979^＊		0.621		3.214^＊＊
性别	24 hDBP（mmHg）			24 hSSD（%）		24 hDSD（%）		24 hPPI
男	67.44±8.78			14.11±4.21		8.52±1.98		0.52±0.06
女	66.97±8.14			13.41±3.08		8.31±2.12		0.49±0.06
t或χ²	0.983			1.916^＊		0.989		4.397^＊＊

季节	n	24 hSBP（mmHg）	24 hDBP（mmHg）	24 hSSD（%）	24 hDSD（%）	24 hPPI	日平均气温（℃）	日温差（℃）	日平均气压（Pa）
春	110	133.60±11.36	65.99±8.79	12.65±2.51	8.28±2.24	0.506±0.055	15.60±8.44	10.34±3.14	1 015.29±10.21
夏	108	128.25±10.72^a	66.18±7.59	11.99±2.35	8.60±1.92	0.491±0.058	24.80±9.48^a	7.27±2.36^a	1 008.42±11.26^a
秋	111	134.13±12.71^b	65.27±8.99	12.82±2.59^b	8.17±1.93	0.511±0.056^b	14.37±6.49^b	8.25±2.61^ab	1 020.02±5.58^ab
冬	109	140.80±14.20^abc	66.25±9.26	14.25±3.01^abc	8.63±2.13	0.522±0.066^abc	0.25±3.12^abc	6.95±2.42^ac	1 029.55±6.35^abc
F		19.477^＊＊	0.294	14.871^＊＊	1.357	5.276^＊	223.200^＊＊	35.728^＊＊	119.138^＊＊

季节	n	24 hSBP（mmHg）	24 hDBP（mmHg）	24 hSSD（%）	24 hDSD（%）	24 hPPI	日平均气温（℃）	日温差（℃）	日平均气压（Pa）
春	110	133.60±11.36	65.99±8.79	12.65±2.51	8.28±2.24	0.506±0.055	15.60±8.44	10.34±3.14	1 015.29±10.21
夏	108	128.25±10.72^a	66.18±7.59	11.99±2.35	8.60±1.92	0.491±0.058	24.80±9.48^a	7.27±2.36^a	1 008.42±11.26^a
秋	111	134.13±12.71^b	65.27±8.99	12.82±2.59^b	8.17±1.93	0.511±0.056^b	14.37±6.49^b	8.25±2.61^ab	1 020.02±5.58^ab
冬	109	140.80±14.20^abc	66.25±9.26	14.25±3.01^abc	8.63±2.13	0.522±0.066^abc	0.25±3.12^abc	6.95±2.42^ac	1 029.55±6.35^abc
F		19.477^＊＊	0.294	14.871^＊＊	1.357	5.276^＊	223.200^＊＊	35.728^＊＊	119.138^＊＊

组别	n	低温组
组别	n	24 hSBP（mmHg）	24 hDBP（mmHg）	24 hSSD（%）	24 hDSD（%）	24 hPPI
H型高血压组	104	138.12±14.29	66.97±9.04	14.78±3.51	8.71±2.58	0.52±0.06
非H型高血压组	116	137.89±13.56	65.83±7.63	13.33±2.57	8.20±2.10	0.52±0.05
t		0.120	0.628	2.196^＊	0.998	1.534
组别	n	高温组
组别	n	24 hSBP（mmHg）	24 hDBP（mmHg）	24 hSSD（%）	24 hDSD（%）	24 hPPI
H型高血压组	96	135.56±13.60	66.71±7.02	13.88±3.26	8.58±2.21	0.51±0.05
非H型高血压组	122	134.11±13.98	65.28±8.56	12.86±2.23	8.47±2.00	0.50±0.06
t		0.162	0.903	1.793	0.746	1.149

季节气象因素对高龄老年原发性高血压病患者血压波动的影响

Influence of seasonal meteorological factors on blood pressure fluctuation in elderly patients with essential hypertension

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变量	未标准化β	SE	标准化β	t	P
常数项	268.412	100.446		2.672	0.008
日平均气温	-0.641	0.117	-0.517	5.485	<0.001
日温差	-0.118	0.192	-0.051	0.981	0.327
日平均气压	-0.122	0.097	-0.121	1.259	0.209

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