Clinical value of synchronous dynamic electrocardiogram and ambulatory blood pressure monitoring in elderly patients with hypertension complicated with atrial fibrillation
Abstract：Objective To investigate the clinical value of synchronous dynamic electrocardiogram and dynamic blood pressure monitoring in elderly patients with hypertension complicated with paroxysmal atrial fibrillation. Methods Eighty-two elderly hypertensive patients were enrolled. According to whether patients with paroxysmal atrial fibrillation, they were divided into group A (39 patients without paroxysmal atrial fibrillation, and their heart function was normal) and group B (43 cases, combined with paroxysmal atrial fibrillation). Forty healthy people in our hospital at the same time were selected as the control group. Synchronous monitoring was performed using an ambulatory blood pressure meter and a dynamic electrocardiograph. The diurnal blood pressure, the occurrence of antidipper hypertension and heart rate variability (HRV) parameters [normal adjacent RR interval standard deviation (SDNN), the root mean square of successive differences of RR interval (RMSSD)] of the three groups were observed. Results The 24 h DBP of (76.65±9.21) mmHg and dmDBP of (77.21±9.84) mmHg in group B were lower than those of (81.29±11.34) mmHg and (82.95±11.56) mmHg in group A (P<0.05). The nmSBP of (128.93±15.92) mmHg in group B was higher than that of (121.36±17.84) mmHg in group A. The 24hSBP, 24hDBP, dmSBP, dmDBP, nmSBP and nmDBP in control group were (110.72±6.31) mmHg, (73.13±4.86) mmHg, (112.06±6.52) mmHg, (74.64±5.40) mmHg, (106.21±5.08) mmHg and (68.24±3.95) mmHg, respectively, which were lower than those of (126.87±15.28) mmHg, (81.29±11.34) mmHg, (128.69±15.97) mmHg, (82.95±11.56) mmHg, (121.36±17.84) mmHg and (76.27±11.84) mmHg in group A. The 24hSBP,24hDBP,dmSBP, nmSBP and nmDBP in control group were lower than those of (124.26±12.94) mmHg, (76.65±9.21) mmHg, (123.46±15.12) mmHg, (128.93±15.92) mmHg, (76.50±9.63) mmHg in group B .The diastolic blood pressure and proportion of anti-dipper systolic blood pressure in group B (32.56%,39.53%) were higher than those in group A (12.82%,17.95%). There were no statistically significant difference in the diastolic blood pressure and proportion of antidipper systolic blood pressure(P<0.05). The SDNN of (84.13±25.90) ms and RMSSD of (41.23±16.59) ms in group B were lower than those in group A [(116.58±30.76) ms, (50.79±21.07) ms] and control group [(136.94±34.01) ms, (62.45±23.17) ms]. There were no statistically significant difference in SDNN and RMSSD (P<0.05). ConclusionThe vagus nerve function is lower in elderly patients with hypertension and paroxysmal atrial fibrillation, and antidipper blood pressure is prone to occur.
李刚, 钟雷, 严婷, 宣骏梅. 动态心电图与动态血压同步监测老年高血压合并房颤的临床价值[J]. 实用心电学杂志, 2019, 28(5): 311-314.
LI Gang, ZHONG Lei, YAN Ting, XUAN Jun-Mei. Clinical value of synchronous dynamic electrocardiogram and ambulatory blood pressure monitoring in elderly patients with hypertension complicated with atrial fibrillation. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2019, 28(5): 311-314.
2019, Vol. 28 
