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Background and Purpose: hypertension as one of the most important cardiovascular risk factors, prevalence and mortality showed an increasing trend. 2009 Collaborative Group of the American Society of Hypertension (ASH) hypertension hypertension nature of the interaction of many causes of complex, progressive vascular syndrome, heart, kidneys, brain tissue and other target organ pathophysiological changes and subclinical or clinical manifestations may occur before the blood pressure. Early detection and intervention of vascular lesions, to assess the risk factors for cardiovascular disease \Recently reported study found that blood pressure variability index has a higher predictive value than traditional systolic, diastolic, and pulse pressure, is closely related with hypertensive target organ damage, and can be used as an independent cardiovascular events predictors. Related research involving the elderly population, especially in the the old elderly population reported less, and involves less reported relationship with the crowd renal blood pressure variability. Therefore, the purpose of this study is mainly the following two aspects: First, ambulatory blood pressure monitoring indicators in the elderly and old elderly population; Second, analysis of blood pressure variability and the country's aging and very elderly male population kidney function. Materials and Methods: from January 2008 to December 2010, was selected in the 60 to 103-year-old elderly (≥ 60 years) men of 485, with an average age of 79.83 ± 10.16 years Geriatric Cardiology, PLA General Hospital ward doctor or hospital very elderly (≥ 75 years) of 334, with an average age of 79.83 ± 10.16 years. Take medical record retrieval methods to collect clinical data entry Excel database: 1 General information: age, height, weight, body mass index (BMI), medical history, family history, drug use, serum total cholesterol (TC), glycerol triacetate (TG ), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), serum creatinine (Cr), blood uric acid (UA), blood glucose (Glu); ② ambulatory blood pressure monitoring indicators of 12 24h systolic blood pressure variability (24hSBP variability), 24h diastolic blood pressure variability sexual the (24hDBP variability), 24 h SBP load (24hSBP load), 24 h diastolic blood pressure load the (24hDBP load), the decline in systolic blood pressure at night (SBP nocturnal decline) , diastolic night decline (DBP night drop). China modified MDRD formula evaluation of the glomerular filtration rate (eGFR), selected cases were divided into three groups according to the level of the eGFR (unit ml/min/1.73m2): eGFR gt; 90 groups, eGFR60-90 group, eGFR lt; 60 group [according to the U.S. National Kidney Foundation (K / DOQI) definition of chronic kidney disease (CKD), CKD defined as eGFR lt; 60ml/min/1.73m2]. General information to compare and ambulatory blood pressure monitoring indicators compare among groups. Then study the cases of elderly and old elderly were divided into two groups, the general comparison of the information with the t test, Pearson correlation and multiple stepwise regression analysis of the variability of blood pressure and renal function. Results: the different eGFR level, age, uric acid, diabetes and coronary heart disease history exists a significant difference (P lt; 0.001), significantly higher eGFR decline, age, uric acid, diabetes, coronary heart disease was significantly increased in each group between hypertension and antihypertensive treatment, no significant difference in the proportion of variability; ambulatory blood pressure monitoring indicators 24hSBP day average systolic blood pressure (daytime SBP), DBP night down there is a certain degree of change, 24hSBP variability with eGFR reduction higher (P = 0.023), daytime SBP with eGFR reduction and increased (P = 0.044), DBP nocturnal decline with the reduction of eGFR decline (P = 0.027), of 24h mean systolic blood pressure or diastolic blood pressure (24hSBP/DBP change) is not due to different eGFR (P = 0.112 / P = 0.643). Study cases according to age stratified, the older group 24hDBP load and mean daytime SBP and eGFR significant correlation (r = 0.18, P = 0.027 / r = -0.23, P = 0.005); very elderly group, 24hSBP variation , DBP nighttime decline with eGFR significant correlation (r = -0.32, P = 0.003 / r = 0.24, P = 0.019). Stepwise multiple regression analysis of different age groups, respectively, the results showed that the older group, hypertension and antihypertensive treatment, UA, daytime SBP eGFR; very elderly group, age, hypertension and antihypertensive treatment, BMI, the UA, 24hSBP variability the eGFR related. Conclusion: This study by ambulatory blood pressure monitoring indicators of the male population of the elderly (including very elderly), measured with the modified MDRD formula eGFR related statistical analysis, and further confirmed by blood pressure variability indicators, especially 24hSBP variation with kidney function are closely related. In old elderly male crowd, 24hSBP variability was negatively correlated with eGFR, and this correlation independent of other traditional cardiovascular risk factors. Different ambulatory blood pressure monitoring indicators in the performance of different ages, different. Predictive value for cardiovascular events associated with hypertensive target organ damage have reported many positive reports, blood pressure variability in recent years has aroused widespread concern of cardiovascular academia, and even scholars as high new blood pressure treatment targets, and this, I think that the need for further research and discussion.
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